Personal Information: Please do not leave any blanks in this section.
First Name
M.I.
Last Name
Social Security #
Date of Birth
Driver's License #
Phone Number
Alternative Number
Email
Co-Applicant:
First Name
M.I.
Last Name
Social Security #
Date of Birth
Driver's License #
Phone Number
Alternative Number
Email
Rental History
Please include all addresses you have lived at for the previous 5 years.
Current Address
Current Address (Street, City, State, ZIP)
Move-In Date
Landlord's Name
Landlord's Phone
Monthly Rent
Reason for Moving
Previous Address
Previous Address (Street, City, State, ZIP)
Move-In Date
Landlord's Name
Landlord's Phone
Monthly Rent
Reason for Moving
Previous Address
Previous Address (Street, City, State, ZIP)
Move-In Date
Landlord's Name
Landlord's Phone
Monthly Rent
Reason for Moving
Employment Information
Please include all sources of income. Use additional paper if needed. Self-employed: Please supply tax returns for previous two years and two most recent banks statements.
Current Employer
Position
Employer Phone Number
Supervisor Name
Gross Wages Per Month
Hire Date
Other Sources of Income
Amount Per Month
Explain
Questionnaire
Please answer all questions truthfully.
How long will you live here?
What pets do you have?
How many evictions have been filed upon you?
How many felonies do you have?
Have you ever broken a lease?
How many vehicles do you own?
Is the total move-in amount available now?
When would you like to move in?
How did you hear about this home?
For what reasons could you not pay rent on time?
Balance
Balance
Emergency Contact Name
Emergency Contact Phone
Relationship (Including to contact regarding rent or tenancy.)
Why should we rent to you?
Additional Information (Please use this optional space for additional information, comments, or explanations.)
Please read carefully and sign and date below if you agree. Applicant certifies that the information contained in this application is true and correct. Applicant understands that false or misleading information is grounds for immediate disqualification. Applicant shall pay to the Landlord a nonrefundable fee to accompany this application to cover the Landlord’s administrative costs and expense to verify the information submitted by the Applicant.
Authorization Applicant authorizes the Landlord or Landlord’s representatives to make any inquires deemed necessary to verify Applicant is the most qualified based on the below stated qualification standards. This verification includes, but is not limited to, direct contact with Applicant’s employers, current landlord, previous landlords, friends, personal and professional references, law enforcement agencies, government agencies, consumer reporting agencies, public records, eviction records, and any other sources of information which the Landlord or Landlord’s representative may deem necessary. Applicant verifies that the Landlord and Landlord’s representatives shall not be held liable for damages of any kind that result from the verification of the information provided. This authorization shall extend through Applicant’s tenancy to ensure continued compliance to the terms of tenancy or to recover any financial obligations relating to Applicant’s tenancy, and beyond the expiration of Applicant’s tenancy for recovery of any financial obligations, or for any other acceptable purpose. Should the Applicant be denied or face other adverse action based on information received in a consumer report, the Applicant has a right to obtain a free copy of the consumer report, and to dispute the accuracy of the information it contains by contacting the Consumer Reporting Agency:
Phone: 860-236-0641
Toll Free: 844-253-1515
Email: office@capcityreporting.com Address:
P.O. Box 270152
West Hartford, CT 06127-0152
Holding Fee
Upon the verbal or written approval of the Applicant’s tenancy, if tenant will not be taking occupancy immediately, a Deposit to Hold Agreement will be executed and signed by all parties and a non-refundable holding fee shall be required within 24 hours, hereinafter referred to as “Deposit to Hold” in the amount equal to one month’s rent to hold the property until a mutually agreed upon move-in date. The Deposit to Hold removes the property from public offering and holds the guest room exclusively for the Applicant until all other requirements have been met. After all requirements have been met and a lease for the property completed, the Deposit to Hold will transfer to the security deposit to be held throughout the tenant’s entire tenancy. If the Applicant fails to provide the Deposit to Hold within 24 hours of approval, the Applicant may be disqualified, and the home will be offered to the next qualified applicant. After approval and before occupancy will be granted, Applicant must supply all the required move-in funds, including the security deposit, first month’s rent, and any other additional deposits and fees, and an agreement must be executed and signed by all parties. If for any reason, the Applicant fails to complete all move-in requirements the landlord will return the property to public offering and the entire Deposit to Hold will be forfeited to the Landlord for expenses including, but not limited to, lost rent, holding costs, advertising costs, and marketing costs.
Qualification Standards
Your Application will be denied if you do not meet the below standards for qualification. Applicant must have current photo identification and a valid social security number.
Applicant's monthly household income must exceed three times the rent. All income must be from a verifiable source. Unverifiable income will not be considered.
Applicants must receive positive references from all previous landlords for the previous 5 years.
Applicant may not have any evictions or unpaid judgments from previous landlords. Applicant must exhibit a responsible financial life. Credit score must be a minimum of 600. A background check will be conducted on all applicants over 18. Applicant’s background must exhibit a pattern of responsibility. Applicant must be a non-smoker. Occupancy is limited to 2 people per guest room.
At landlord’s discretion, compensating factors such as an additional security deposit or co-signer (guarantor) may be required for qualification if Applicant fails to meet any one of the above requirements. In the event of multiple applicants, tenancy will be granted to the most qualified, based on the above criteria.
Applicant authorizes release of all information to Landlord and agrees that the information provided in this rental application is true and correct. This authorization extends beyond the end of Applicant’s tenancy.
Applicant's Name (typed name will serve as your Signature)
Co-Applicant's Name (typed name will serve as your Signature)
Today's Date
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