This document is a rental application form that collects information about applicants, additional occupants, rental history, employment history, credit history, vehicles, references, and includes an agreement signature. It requests information such as names, birthdates, social security numbers, driver's license numbers, phone numbers, emails, addresses, employers, supervisors, monthly incomes, account balances, credit cards, loans, vehicle details, references, and signatures agreeing to a background check.

1. Rental Application Form
Applicant #1
First Middle Last Birthdate Social Security # Driver’s License #
Cell Phone Number Email Address
Applicant #2
First Middle Last Birthdate Social Security # Driver’s License #
Cell Phone Number Email Address
Additional Occupants
Names Birthday Relationship
Rental History
Current Residence Previous Residence Prior Residence
Street Address
City
State & Zip
Owner/Manager Name
Owner/Manager Number
Reason for leaving
Is/Was rent paid in full?
Did you give a notice?
Evicted?
From/To From/To From/To
Dates of Residency
Employment History
Applicant Name:
Current Employment Previous Employment Prior Employment
Employed By
Address
Employer’s Phone
Occupation
Name of Supervisor
Monthly Gross Pay
From/To From/To From/To
Dates of Employment

2. Additional Employment History
Applicant Name:
Current Employment Previous Employment Prior Employment
Employed By
Address
Employer’s Phone
Occupation
Name of Supervisor
Monthly Gross Pay
From/To From/To From/To
Dates of Employment
Credit History
Bank name Current Balance
Savings Account
Checking Account
Checking Account
Other:
Bank name Amount Owed
Credit Card
Credit Card
Auto Loan
Auto Loan
Vehicles
Make Model Year License Plate #
References & Emergency Contacts
Name
Street Address
City
State & Zip
Phone Number
Agreement & Authorization Signature
I believe that the statements I have made are true and correct. I hereby authorize a credit and/or criminal check
to be made, verification of information I provided and communication with any and all names listed on this
application. I understand that any discrepancy or lack of information may result in the rejection of this
application. I understand that this is an application for a single-family house rental and does not constitute a
rental or lease agreement in whole or part.
Signature: _ _ Date: _ _
Signature: _ _ Date: _ _