Full Name:

Date of Birth:

Phone Number:

Email Address:

Current Address:

Emergency Contact Name:

Emergency Contact Phone Number:

How did you hear about our rental properties?

Desired Move-In Date:

Desired Lease Term (Months):

Preferred Rental Property Type:

• single-family home

• apartment

• condominium

Other (Please specify):

Number of Bedrooms Desired:

Number of Bathrooms Desired:

Do you have any pets? If yes, please specify type and size:

Are you a smoker?

Monthly Income (before taxes):

Employment Status:

Current Employer:

Length of Employment:

Do you have any additional sources of income?

• Yes

• No

If Yes, please provide details:

Have you ever been evicted from a rental property?

• Yes

• No

If Yes, please provide details:

Do you have any outstanding debts or judgments?

• Yes

• No

If Yes, please provide details:

Will there be any additional occupants besides yourself?

• Yes

• No

If yes, please provide their names and ages:

Will you require parking?

• Yes

• No

If yes, how many spaces?

Landlord/Property Manager Name:

Phone Number:

Email Address:

Rental Property Address:

Dates of Tenancy:

[Month, Day, Year]