Through the information reflected in this form, the landlord will be able to review a prospective tenant’s credit history and relevant background. As such, the landlord will be able to decide whether to approve or reject the lease application.Download
Extracted Text for Proper Search
APPLICATION TO RENT POTENTIAL LANDLORD’S INFORMATION : Name of Landlord: ______________________________________ Landlord’s Phone Number: ____________________ Landlord’s Address: _______________________________________________________ (send application here). Apartment Address: _______________________________________________________________________________ Monthly rent: $________________* Security deposit: $__________________* Available date: ____________ * First month’s rent and security deposit are to be paid by cashier’s check or cash. PLEASE PRINT ALL INFORMATION INCOMPLETE APPLICATIONS WILL BE REJECTED! PERSONAL INFORMATION : Name: ____________________________________________ DOB: _____________ SS#: _____________________ Current Address:_________________________________________________________________________ Current Phone Number:______________________________ E-mail address: _______________________________ Identification - Driver’s License/Passport No.: _____________________ Other: ___________________ Please provide the following for each location you have resided over the previous three (3) years: Landlord’s Name Landlord’s phone # Address of the Unit Dates of Residence Reason for Leaving Does Current Landlord know you are leaving the apartment/house? Yes No VEHICLE INFORMATION : Vehicle #1 Vehicle #2 Type of Vehicle Make Model Year Color VIN License Plate State Registered In Employment or Source of Funds Financial Information Name of Employer/ Source of Funds Checking Account # Phone Number Bank Name & City Supervisor Savings Account # Position Bank Name & City Employed Since Credit Cards? Yes No Gross Monthly Salary/Funds Type of Credit Card(s)? Mastercard Visa AmEx Discover Other Sources of Funds & Amount PERSONAL REFERENCES : Name: _________________________________ Address: ____________________________________________ Telephone #: (______)_____________________ Relationship to Applicant: ______________________________ Name: _________________________________ Address: ____________________________________________ Telephone #: (______)_____________________ Relationship to Applicant: ______________________________ Name: _________________________________ Address: ____________________________________________ Telephone #: (______)_____________________ Relationship to Applicant: ______________________________ MISCELLANEOUS : Question Yes No Explanation • Do you own any real estate? Where? • Do you have any pets? If yes, please fill out and submit the Pet Resume • Have you ever been arrested or charged with a crime? • Have you ever received an Eviction Notice from a landlord? • Have you ever been evicted by a landlord? • Do you smoke? EMERGENCY CONTACTS : In case of emergency notify: Name: _______________________________________ Telephone #:______________ Address: ___________________________________ Relationship: ______________ SIGNATURES AND RELEASE OF INFORMATION Please read the following prior to signing this Rental Application. I warrant that the information supplied is true and correct, and that I am at least 18 years of age. I hereby authorize ________________________________ (“Lessor”) and its designee, ScreeningOne, Inc., 2233 W. 190 th Street, Torrance, CA 90504, (866) 273-3848, and its designated agents and representatives (individually and together (“ScreeningOne”), to conduct a comprehensive background check that includes any one or all of the following: Consumer and/or business credit report, past employment and tenancy, criminal, drug, and driving records. I understand that one or more of the above-referenced checks may require additional written authorizations and consents, and I hereby agree to provide all such further written authorizations and consents. I am aware that the background reports I consent to have prepared may include information obtained from a variety of sources, including but not limited to government agencies, national credit reporting agencies, and other sources. I am aware that if I choose, I may obtain a complete disclosure of the nature and scope of any report prepared about me if I make a written request to ScreeningOne, within a reasonable time after I execute this authorization. I also authorize and request every person, firm, company, corporation, governmental agency, court, law enforcement office, and any other entity having control or possession of any information pertaining to me or my background to furnish same to ScreeningOne. By this authorization, I hereby forever release, discharge, exonerate, hold harmless and indemnify Lessor, ScreeningOne, and their affiliates, employees, representatives, agents, and subcontractors, and any other person, entity, organization or institution furnishing information to them, from any and all liabilities of every nature and kind, including but not limited to claims for libel, slander invasion of privacy, related tort claims, misuse of the information obtained, and any other claim or cause of action arising out of the furnishing, inspection or copying of any documents, files, records, and other information, or the investigation made by or on behalf of Lessor or ScreeningOne, unless such release is determined to violate the public policy of the state or federal district in which this contract is executed, and in that event this release will be permitted to the maximum extent allowed by the governing law. I understand that a photocopy, facsimile or scanned copy of this signed document shall be considered as valid as an original. I have been informed that my credit will be used to evaluate my qualifications as a potential tenant. Any information derived from credit reports or other sources will be kept confidential and not revealed to any outside party. I hereby acknowledge that false information given in this Rental Application may constitute grounds for rejection of this application and termination of your lease. I hereby acknowledge that incomplete Rental Applications will be rejected. I authorize listed references, including employers and financial institutions, to release information to Lessor (Landlord). I, the undersigned Applicant(s), have read and agree to all provisions of this Rental Application. Signature: __________________________________________ Printed Name: ____________________________________ Date: ________________________ Current Address: _______________________________________________________________________ PLEASE RETURN TO THE LANDLORD Form Created by: VERMONT APARTMENT OWNERS ASSOCIATION, LLC PO Box 701, Shelburne, Vermont 05482-0701 www.vaoa.com • 1-888-LOW RENT © Vermont Apartment Owners Association, LLC 2007. All rights reserved.