Residential Lease Application

Each applicant must fill out a separate application. Application fee is $50.00

Application Date:

Address Applied For

Monthly Rent:

Lease Term:

Lease Start Date:

Applicant Information

First Name

Middle Name

Last Name

SSN

Cell Phone#:

Date of Birth:

Driver’s License#:

State:

Email Address:

Current Address

Street Name:

City/State:

Zip Code:

Lease Start Date:

Lease End Date:

Reason For Leaving:

Landlord Name:

Landlord Email:

Landlord Phone:

Monthly Rent:

Previous Address:

Street Name:

City/State:

Zip Code:

Lease Start Date:

Lease End Date:

Reason For Leaving:

Landlord Name:

Landlord Phone:

Monthly Rent:

Employment Information

Employer

Start Date:

Occupation

Supervisor Name

Supervisor Email

Supervisor Phone:

Annual Salary

Other income:

Source:

References

Business:

Address

City/State/Zip

Phone

Personal:

Address

City/State/Zip

Phone

Banking:

City/State/Zip

Notify incase of emergency

Name

Relationship

Address

City/State/Zip

Phone

Name

Relationship

Address

City/State/Zip

Phone

Vehicle information

Year

Make

Model

Color

Plate#

Pets

Type

Breed

Sex

Color

Size

Other occupants

List names and birthdates of all additional occupants 18 years and older:

List names and birthdates of all dependents 18 years or younger:

I warrant that all statements contained in this application are true and accurate and that I have not knowingly withheld any information which would ,if disclosed, affect my application favorably. The applicant/s authorize/s DPI Rentals and/or its agent to order credit reports, criminal background checks, and any other reasonable tenant screening reports from third party providers. The applicant/s also authorize/s to contact past and present employers, landlords, and/or neighbors to verify employment, income, and rent payment history. This information can include, but is not limited to duration of stay, rent amounts, payment history, apartment condition upon my departure, and issues concerning compliance with or infringement on the policies and provisions in the Housing Agreement. This information may be provided to landlords with whom I am seeking tenancy. Any person or firm is authorized to release information pertaining to my credit history or suitability as a tenant upon presentation of this form or a photocopy of this form. I understand that a $50 dollars fee associated with this application will be paid by me/the applicant, along with deposit and first month of rent, if my application is approved and rentals contract is signed. I understand that application fee is applied to each and every applicant.

Date

Applicant Signature