Rental Credit Application Form
Personal Information
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Interviewer
First Name
Last Name
Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Applicicant
First Name
Last Name
Date of Birth
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Driver's Licence #
Present Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How long have you lived at present address?
Landlord's Name
First Name
Last Name
Landlord's Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Previous Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How long have you lived at previous address?
Previous Landlord's Name
First Name
Last Name
Previous Landlord's Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
How many people living in the house?
Rows
Number
Adults
Children
Please give information about the pets living in the house
*
Your Occupation
Your Current Salary $
Your Employer
First Name
Last Name
Spouse Information
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Name of Spouse
First Name
Last Name
Date of Birth
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Social Security #
Driver's License #
Occupation
Employer
First Name
Last Name
Current Salary $
Has your spouse ever filed for bankruptcy?
Yes
No
Bank Information
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Name of the Bank
Branch
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Checking account #
Savings account #
References
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Personal References
Rows
Name
Relationship
Phone Number
1
2
3
Credit References
Rows
Credit Grantor
Adress
Phone Number
1
2
3
Other Information
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Number of Vehicles
Details
*
Have you ever filed for bankruptcy?
Yes
No
When?
Have you ever been served an eviction notice or been asked to vacate the your renting property ?
Yes
No
Have you ever intentionally refused to pay rent when due?
Yes
No
Have you ever been sued for unlawful detainer?
Yes
No
Where did you hear us?
Rental Unit applied for
Date of Commencement
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Term
Rent/Month
Acknowledgement & Consent
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I, applicant, acknowledge the following statements
The leasing agent is the representative for the owner/landlord and leasing agent’s fees will be paid by the owner/landlord.
This written notice was received before I receive the lease agreement.
I, applicant, am giving consent to the following statements
I authorize my/our credit qualifications and all the information I provided to be investigated by you.
I release all persons, agencies, or firms could be liable resulting from providing such information.
Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Applicant's Signature
Co-Applicant's Signature
Submit
Should be Empty: