Online Rental Application

Renter Information

Date

Desired Lease Date

Applicant's Name

Desired Property Address

Street Address Address Line 2 City State ZIP Code

Phone Number

Driver's License # and State

Email

Date of Birth

Names of persons living on the premises

Do you own a pet?

Yes
No

Type of pet

Do you own an automobile?

Yes
No

Automobile Make

Year

State

License Plate #

Previous Rental Information

Present Address

Street Address City State ZIP Code

Landlord Name or Company and Phone #

Length of Time at Present Address

Previous Landlord or Company Name and Phone #

Employment Information

Employer and Phone #

Position and Length of Employment

Salary and Full-Time/Part-Time

Immediate Supervisor's Name

Employed From / To

Present Source of Income and Amt. per Month

If you are receiving student financial aid or scolarships, please indicate source of aid and the amount

Other sources of funds which you use to pay living expenses

Credit Information

Credit Reference #1 (name, address, phone)

In Case of Emergency contact (name, address, phone, relationship)

Have you ever filed for bankruptcy?

Yes
No

Date Filed?

Have you ever been evicted?

Yes
No

Have you ever been convicted of a felony?

Yes
No

Terms of Service*

Accept

I (we) hereby make application for occupancy of the described apartment home on the terms specified. The actual date of possession is subject to timely vacation of the premises by prior tenants, and the completion of necessary repairs or cleaning. If this application is approved, I (we) agree to enter into an Agreement of Lease for the apartment /home, terms and rental as outlined herewith. At the time the Agreement of Lease is executed, the full Security deposit is due and payable to lessor. The Security Deposit will be held, without interest, as security for the performance of the covenants of the lease and as a damage deposit. I (we) affirm the above information to be true and correct. All persons and/or firms named above may freely give any requested information concerning me (us) and I (we) hereby waive all right of action for any consequence resulting from such information. Further, I (we) give my (our) permission to FaciliTech Management to run a credit check on my (our) name(s) with a credit agency.

Phone

This field is for validation purposes and should be left unchanged.

Renter Information

Previous Rental Information

Employment Information

Credit Information

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