Link to printable application in Word and PDF
Example RESIDENTIAL RENTAL APPLICATION
Landlord
Landlord Name: Rosin Arcade LLC
Address: Office # 109, 100 West Oak Street, Arcadia, Florida 34266
Phone: (863) 491 6419
Rental Property Information
Rental Property Address: 100 West Oak Street, Arcadia Florida 34266
Application to rent Unit: Apartment Number 201
The term of the tenancy will be a fixed term starting on 1 September 2019 and ending on 29 August 2020.
Possession Date: 1 September 2019
Monthly Rent Payment: $600.00
Initial Security Deposit: $700.00
Applicants' Personal Information
Applicant's Name: ____________________________________________________________________
Home Phone: _________________________ Alternative Phone: _________________________
Email Address (Optional): ________________________ Date of Birth: ___________________
Second Applicant's Name: ______________________________________________________________
Second Applicant's Date of Birth: ________________________________________________________
Third Applicant's Name: _______________________________________________________________
Third Applicant's Date of Birth: _________________________________________________________
Name(s) of Dependent(s): Date(s) of Birth:
__________________________________________ ____________________________
__________________________________________ ____________________________
__________________________________________ ____________________________
__________________________________________ ____________________________
__________________________________________ ____________________________
Do you have a pet? Yes / No If more than one, how many? _______
Please describe type(s) of pet(s):
____________________________________________________________________________
____________________________________________________________________________
Residential History
Present Address: ____________________________________________________________________
City:__________________________________ State/Territory:____________________________
Postcode:_________________ How long at this address? _______________________________
Landlord / Lessor: ___________________________ Phone: _________________________
Previous Address 1: _________________________________________________________________
City:__________________________________ State/Territory:____________________________
Postcode:_________________ How long at this address? _______________________________
Landlord / Lessor: ___________________________ Phone: _________________________
Previous Address 2: _________________________________________________________________
City:__________________________________ State/Territory:____________________________
Postcode:_________________ How long at this address? _______________________________
Landlord / Lessor: ___________________________ Phone: _________________________
Details of Employment
Employer:______________________________________________________________________
Position: _________________________________ Date Hired: ______________________________
Supervisor's Name: __________________________ Phone: _________________________
Salary: _________________________
(If employed less than one year with present employer, please provide previous employer.)
Employer:______________________________________________________________________
Position: _________________________________ Date Hired: ______________________________
Supervisor's Name: __________________________ Phone: _________________________
Salary: _________________________
Other Sources of Income
Do you receive income from any of the following sources? Yes / No
Student Loans ______ Pension Benefits ______ Social Assistance ______ Other ______
Please provide contact persons who could verify the amount of additional income you receive:
__________________________________________________________________________
__________________________________________________________________________
Vehicle Information
Make / Model: ___________________________________ Year: ________________
Number Plate: _______________________ Driving Licence Number: __________________
Make / Model: ___________________________________ Year: ________________
Number Plate: _______________________ Driving Licence Number: __________________
Parking space required? Yes / No Additional space required? Yes / No (Subject to availability)
Banking Information
Banking Institution: ________________________________________________________________
Address: _________________________________ Phone: _________________________
(If you bank with more than one institution, please list second bank below)
Banking Institution: ________________________________________________________________
Address: _________________________________ Phone: _________________________
References
Name: ____________________________________ Phone: _________________________
Name: ____________________________________ Phone: _________________________
Emergency Contact
Name: ____________________________________________
Relationship: ______________________________ Phone: _________________________
Criminal & Credit Background Check Authorisation
Is there anything negative that we may find in our criminal or credit background check that you want to comment on?
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
I declare that the information I have provided is accurate. I authorise the individual or organisation to whom this application is submitted to: (a) contact my references and all other persons that I have named in this application; and (b) perform a credit and/or criminal check to assess my suitability as a tenant/lessee.
Applicant's Signature _____________________________ Date __________________________