Rental Applicant Screening Checklist Form
Complete this form to screen a prospective rental applicant’s basic suitability, rental history, income stability, and household details for the selected property.
Applicant and Rental Basics
Applicant Full Name
*
First Name
Middle Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Property/Apartment Applied For
*
Desired Move-In Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Intended Lease Term
*
6 months
12 months
18 months
Other
Occupancy and Household Details
Number of Adult Occupants
*
Number of Children or Dependents
*
Pets in Household
*
No pets
Cat(s)
Dog(s)
Other
Smoking Preference
*
Non-smoking
Smoking allowed
Either
Employment and Income Screening
Employment status
*
Employed full-time
Employed part-time
Self-employed
Student
Retired
Unemployed
Employer or source of income
Monthly gross household income (USD)
*
Length of current employment or income source
Please Select
Less than 6 months
6–12 months
1–2 years
More than 2 years
Other
Rental History and References
Current Address
*
Current Landlord or Property Manager Name
*
How Long Have You Lived There?
*
Reason for Leaving Current Housing
Can You Provide Rental References?
*
Yes
No
Unsure
Screening Checklist and Occupancy Standards
Screening Criteria
*
Rows
Yes
No
Unknown
Steady income verified
1
2
3
Acceptable rental history
4
5
6
No prior eviction concerns
7
8
9
Able to meet occupancy limits
10
11
12
Willing to provide references
13
14
15
Occupancy Standards Met
*
Yes
No
Unknown
Rental History Acceptable
*
Yes
No
Unknown
References Willingness Confirmed
*
Yes
No
Unknown
Screening Notes
Submit Application
Should be Empty: