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RENTAL APPLICATION

(SUBJECT TO OWNER’S APPROVAL) DATE NUMBER

NAME OF APPLICANT HOME PHONE/CELL PHONE INITIAL IF OVER 18 YRS OF AGE PRESENT ADDRESS PRESENT CITY, STATE, ZIP NO. OF YRS AT ADDRESS PREVIOUS ADDRESS PREVIOUS CITY, STATE, ZIP NO. OF YRS AT ADDRESS AUTOMOBILE: YR/MAKE/ LIC PLATE NO., STATE SOCIAL SECURITY NO.

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DATE OF BIRTH DRIVER’S LICENSE NUMBER DRIVER’S LICENSE STATE OCCUPATION SOURCE OF INCOME TYPE OF BUSINESS SALARY LENGTH OF EMPLOYMENT EMPLOYER’S ADDRESS EMPLOYER’S PHONE PRESENT LANDLORD’S NAME PRESENT LANDLORD’S ADDRESS PRESENT LANDLORD’S PHONE PREVIOUS LANDLORD’S NAME PREVIOUS LANDLORD’S ADDRESS PREVIOUS LANDLORD’S PHONE 1. PERSONAL REFERENCE NAME ADDRESS PHONE

2. PERSONAL REFERENCE NAME ADDRESS PHONE

NAMES OF ALL CO-TENANTS (EACH ADULT MUST FILE A SEPARATE APPLICATION 1. AGE: 2. AGE: 3. AGE: 4. AGE: 5. AGE: APARTMENT NO. /TYPE TOTAL NO. OF OCCUPANTS BASE RENT PER MONTH SECTION 8 OFFICER’S NAME SECTION 8 OFFICER’S PHONE (EXT) REASONS FOR MOVING OUT I Certify the above information is correct and complete, and I authorize you to make any inquiries you feel necessary to evaluate my tenancy including retail credit, if I rent the unit I understand the information contained on this form and rental agreement may be maintained in a tenant database for up to 6 years after I vacate, to be made available to other landlords. Signature: Date: RHA

Rental Housing Application