Residential Rental Application

Property Owner/Manager Name: _________________________________________________

Address of Rental Property:  _______________________________ City:_________________

State:_________________________________________________  Zip Code: ____________

Available for Move-In Date:                                         Lease Duration:

APPLICANT INFORMATION

Name: Date of Birth
Social Security No.: Driver’s License No:                                  State:
Phone: Email address:

 RENTAL HISTORY

Present

Address:  ___________________________________   City:____________________

Province:________________________________    Postal Code:______________

Duration renting at present address? Current rent payment:  $
Landlord’s Name: __________________________     Landlord Phone: __________________

May we contact?   q Yes   q  No

Reason for moving?

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