TenantRental ApplicationProperty: ____________________________________How Referred: _                                                              __

Applicant Information
Name:                                                                                         Drivers License State/Number:                                                                    ­
Date of birth: SSN: Phone:
Current address:
City: State: ZIP Code:
Own         Rent        (Please circle) Monthly payment or rent: How long?
Previous address:
City: State: ZIP Code:
Owned     Rented    (Please circle) Monthly payment or rent: How long?

Employment Information
Current employer:
Employer address: How long?
Phone: E-mail: Fax:
City: State: ZIP Code:
Position: Hourly      Salary     (Please circle) Annual income:
       
     

Emergency Contact
Name of a person not residing with you:
Address:
City: State: ZIP Code: Phone:
Relationship:

Co-applicant Information

 
 Name:                                                                                     Driver’s License State/Number:
 Date of birth:  SSN:  Phone:
 Current address:
City: State: ZIP Code:
 Own         Rent        (Please circle)  Monthly payment or rent:  How long?
 Previous address:
City: State: ZIP Code:
Owned     Rented    (Please circle) Monthly payment or rent: How long?

Co-applicant Employment Information
Current employer:
Employer address: How long?
Phone: E-mail: Fax:
City: State: ZIP Code:
Position: Hourly      Salary     (Please circle) Annual income:

Applicant References
 Name:  Address:  Phone:
Name: Address: Phone:

Additional Applicant Information
Has applicant, co-applicant or any other occupant ever been convicted of a Felony:                      Yes     No     (Please circle)
Has applicant or co-applicant ever filed bankruptcy:                                                                  Yes     No     (Please circle)
Has applicant or co-applicant ever lost property due to foreclosure:                                            Yes     No     (Please circle)
Has applicant or co-applicant ever had any credit problems:                                                      Yes     No     (Please circle)
Has applicant or co-applicant ever been evicted:                                                                      Yes     No     (Please circle)
If the answer to any of the preceding questions is YES, explain (attach additional sheet(s) if necessary:
 
 
If applicant is a member of the Armed Forces:
Has applicant requested or received military orders transferring applicant within one year:           Yes     No     (Please circle)
Is applicant presently serving temporary duty limiting applicants stay to one year or less:            Yes     No     (Please circle)
If applicable:
Pets:   Yes   No     (Please circle) Type/Breed: Weight:
Age:
Current Veterinarian: State: Phone:

OTHER OCCUPANTS Name all Persons to Occupy

 N
 Name: Relationship: Age: 
 Name: Relationship: Age:
 Name: Relationship: Age:

AUTHORIZATION
I authorize the verification of the information provided on this form as to my credit and employment.   I have received a copy of this application.  REPRESENTATION:    Applicant and Co-Applicant represent that the above statements are true and complete.  Providing false information is grounds for rejection, termination of lease, and retention of money tendered to Landlord as liquidated damages. AUTHORIZATION:  Applicant and Co-Applicant authorize Landlord or Landlord’s broker to:  (1) Obtain a copy of any consumer or credit report related to this application.  (2) Verify any rental history, employment history, or any other information related to this application.  (3)  Discuss information in the consumer report with Landlord and Landlord’s broker. FEES:  Applicant has submitted the following:    Non-refundable fee of $50.00 to The Moody Group to process this Application. (Cash or Money Order only please) 
 Signature of applicant:  Date:
 Signature of co-applicant:  Date: