1. Property and Applicant
Property applied for: [PROPERTY ADDRESS, UNIT]. Requested move-in date: [DATE]. Requested lease term: [TERM, e.g. 12 months]. Monthly rent: [RENT AMOUNT]. Applicant full legal name: [APPLICANT NAME]. Date of birth: [DATE OF BIRTH]. Phone: [PHONE]. Email: [EMAIL]. Other adult occupants (each must submit a separate application): [NAMES]. Minor occupants: [NUMBER]. Pets: [TYPE AND NUMBER, or NONE].
2. Rental History
Current address: [CURRENT ADDRESS], from [DATE] to present. Current landlord or manager: [NAME, PHONE]. Current rent: [AMOUNT]. Reason for moving: [REASON]. Previous address: [PREVIOUS ADDRESS], from [DATE] to [DATE]. Previous landlord: [NAME, PHONE]. Have you ever been evicted or asked to leave a rental? [YES / NO]. If yes, explain: [EXPLANATION].
3. Employment and Income
Current employer: [EMPLOYER NAME], position [TITLE], since [DATE]. Supervisor contact: [NAME, PHONE]. Gross monthly income: [AMOUNT]. Other income (source and amount): [DETAILS]. The Applicant agrees to provide reasonable proof of income, such as [PAY STUBS / BANK STATEMENTS / OFFER LETTER], on request.
4. References and Emergency Contact
Personal reference (not a relative): [NAME, RELATIONSHIP, PHONE]. Emergency contact: [NAME, RELATIONSHIP, PHONE].
5. Application Fee and Holding Deposit
Application fee: [AMOUNT, or NONE], which covers the cost of screening and is [NON-REFUNDABLE / REFUNDABLE IF NO SCREENING IS PERFORMED], to the extent permitted by law. Holding deposit, if any: [AMOUNT], which will be [APPLIED TO THE FIRST MONTH'S RENT OR SECURITY DEPOSIT / RETURNED] if the application is approved or declined, as described here: [TERMS]. Some states and cities cap or prohibit application fees and holding deposits.
6. Consent to Credit and Background Check
The Applicant authorizes [LANDLORD NAME] and its screening provider, [SCREENING COMPANY, if known], to obtain consumer reports, including credit, eviction, and (where lawful) criminal background reports, and to contact the landlords, employers, and references listed above to verify the information in this application. The Applicant understands that if an application is denied in whole or in part because of information in a consumer report, the Applicant will receive a notice naming the reporting agency and describing the right to obtain a free copy of the report and to dispute its accuracy.
7. Fair Housing Statement
[LANDLORD NAME] does not discriminate on the basis of race, color, religion, sex, national origin, familial status, disability, or any other characteristic protected by federal, state, or local law. All applicants are evaluated against the same written criteria: [SUMMARY OF CRITERIA, e.g. income of at least 3x rent, verifiable rental history].
8. Applicant Certification
The Applicant certifies that the information in this application is true and complete. False or misleading information may be grounds for rejecting the application or, if discovered after a lease is signed, for remedies available under the lease and the law. This application is not a lease, and submitting it does not guarantee that a lease will be offered.
9. Signatures
The Applicant agrees that this application and consent may be signed electronically. APPLICANT: [APPLICANT NAME] Signature: ____________________ Date: [DATE] RECEIVED BY [LANDLORD / PROPERTY MANAGER NAME] Signature: ____________________ Date: [DATE]