Rental Application

Applicant Information
First Name*
Middle Name*
Last Name*
Date of Birth*
Date Format: MM slash DD slash YYYY
Social Security*
Phone*
Email Address*
Driver’s Lic No & State*
Names and ages of individuals who will be living in unit*

Residential History
Current Address:*
Address City State / Province / Region ZIP / Postal Code
Are you renting this address?*
- Yes
- No
Landlord Name / Landlord Company Name*
Landlord Phone*
Monthly Rent*
Move-In Date*
Date Format: MM slash DD slash YYYY
Move-Out Date*
Date Format: MM slash DD slash YYYY
Reason for leaving*
Previous Address (If within 3 years)*
Address City State / Province / Region ZIP / Postal Code
Did you rent at this address?*
- Yes
- No
Landlord Name / Landlord Company Name*
Landlord Phone*
Monthly Rent*
Move-In Date*
Date Format: MM slash DD slash YYYY
Move-Out Date*
Date Format: MM slash DD slash YYYY
Reason for leaving*

Employment History
Your Status*
- Employed full time
- Employed part time
- Student
- Retired
- Not employed
Current employer (or most recent)*
Address*
Employer Phone number*
Dates employed from*
Date Format: MM slash DD slash YYYY
Dates employed to*
Date Format: MM slash DD slash YYYY
Position*
Supervisor Name*
Supervisor #
Net monthly salary*
Household Net Monthly Income*
Previous employer*
Address*
Previous Employer Phone number*
Dates employed from*
Date Format: MM slash DD slash YYYY
Dates employed to*
Date Format: MM slash DD slash YYYY
Position*
Supervisor Name*
Supervisor #
Net monthly salary*
Source of Any Other Household Income*
Amount*

Bank and Personal Reference Checks
Your bank(s)*
Add Bank*
Your bank(s) City/ State/ Branch Telephone
Add Personal References*
Personal References City/ State Telephone
Vehicle Information
Total number of vehicles (including company cars)*
Make/ Model*
Make/ Model
Year*
Year
Color*
Color
Tag no./ State*
Tag no./ State

Emergency Contact Information
Name*
Relationship of the emergency contact person*
Full address*
Home Phone*
Cell Phone*
General Information
Have you ever been convicted of, or pleaded guilty or no contest to, any criminal offense(s) (other than a minor traffic violation) or had any criminal offense(s) disposed of other than by an acquittal or a finding of “not guilty”?*
When and Explain*
Have you ever been convicted of a sexual offense that requires mandatory address registration with federal, state, or local law enforcement agency?*
When and Explain*
Do you have charges pending against you for any criminal offense(s)?*
When and Explain*
Have you ever been sued for non-payment of rent?*
When and Explain*
Have you ever broken a rental agreement or lease?*
When and Explain*
Have you been sued for damage to property?*
When and Explain*
Have you ever been evicted or asked to leave a rental property?*
When and Explain*
Have you ever declared bankruptcy?*
When and Explain*

Application Authorization
1. The management relies on the information given above to be complete and accurate in order to act on your application in a timely manner. Any false statements, misrepresentations, inaccurate information or failure to supply the data requested above may serve as a rejection of your application or grounds for an eviction action if later discovered to be false, misrepresented, inaccurate or incomplete information.

2. By signing the application, you are authorizing the use of any credit reporting/ screening agencies to verify credit, validate accuracy of all information recorded above. Further, your signature authorized the management and the credit reporting/screening agencies to later exchange credit information and access your credit report in the event of default of the lease agreement for collection or skip tracing purposes.

3. I warrant that all of the representations in this application are true and correct. I also understand that information provided on this application shall survive approval of this application, and execution of lease agreements.

4. I understand that occupancy of the apartment is limited to the persons identified on this agreement. I remain responsible for all occupancy, guests, and invitees to my apartment.

5. I agree to submit to lessor valid photo identification (such as state drivers license).

6. I understand that gas, electric, and water/sewer usage is the responsibility of the resident.
I hereby apply to lease the above described premises for the term and upon the conditions above set forth and agree that the rental is to be payable the 1st day of each month in advance. As an inducement to the owner of the property and to the agent to accept this application I warrant that all statements above set forth are true; however, should any statement made above be a misrepresentation or not a true statement of fact the owner or his agent may reject, without stating any reason for so doing, the applicant, thereby waiving any claim for damages by reason of non-acceptance.
I recognize that as part of your procedure for processing my application, an investigative consumer report may be prepared whereby information is obtained through personal interviews with my neighbors, friends, and others with whom I may be acquainted. This inquiry includes information as to my character, general reputation, personal characteristics, and mode of living. I understand that I may have the right to make a written request within a reasonable period of time to receive additional, detailed information about the nature and scope of this investigation.

The above information, to the best of my knowledge, is true and correct.
Signature*
Date
Date Format: MM slash DD slash YYYY
*
I have read and agree to the NLA Real Estate Holdings,LLC Privacy Policy and Terms and Conditions. *
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Rental Application

Notice: Co- Applicant and anyone over 18 must complete a separate rental application form

Rent Application

Step 1 of 6

Applicant Information

Residential History

Employment History

Bank and Personal Reference Checks

Vehicle Information

Emergency Contact Information

General Information

Application Authorization

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