Rental Application

Step 1 of 10

Today's Date*
Date Format: MM slash DD slash YYYY
Desired Bedrooms*
Desired Move In Date*
Date Format: MM slash DD slash YYYY
Floor Preference
Referred by:
SEPARATE APPLICATION REQUIRED FROM EACH APPLICANT AGE 18 OR OLDER PLEASE FILL OUT COMPLETELY. INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED

APPLICANT
Full Name (Include all names used)*
Age*
Home Phone*
Cell Phone*
Work Phone*
Email*
Social Security Number*
Drivers License #*
Driver License State*
Vehicle Make*
Vehicle Model*
Vehicle Color*
Vehicle Year*
License Plate Number*
License Plate State*

ADDITIONAL OCCUPANTS
Do you have additional occupants?
List everyone, including children who will live with you
Full Name*
Relationship to Applicant*
Age*
Full Name
Relationship to Applicant
Age
Full Name
Relationship to Applicant
Age

RENTAL HISTORY – PLEASE INCLUDE STREET ADDRESS, CITY, STATE AND ZIP CODE
Current Address*
City*
State*
Zip Code*
Current Monthly Rent*
Dates Lived at Address*
Reason for Moving*
Landlord/Manager*
Landlord/Manager Phone*
Previous Address 1
City
State
Zip Code
Previous Monthly Rent
Dates Lived at Address
Reason for Moving
Landlord/Manager
Landlord/Manager Phone
Previous Address 2
City
State
Zip Code
Previous Monthly Rent
Dates Lived at Address
Reason for Moving
Landlord/Manager
Landlord/Manager Phone

EMPLOYMENT HISTORY
Name of Current Employer*
Current Employer Address*
Street Address City State / Province / Region ZIP / Postal Code
Name of Supervisor*
Supervisor's Phone*
Dates Employed at This Job*
Position or Title*
Name of Previous Employer*
Current Employer Address*
Street Address City State / Province / Region ZIP / Postal Code
Name of Supervisor*
Supervisor's Phone*
Dates Employed at This Job*
Position or Title*

INCOME
1. Your gross monthly income (before deductions)*
2. Average monthly amounts of other income (specify sources)
Source #1
Source #2
Total Income:*

CREDIT AND FINANCIAL INFORMATION
Bank Institution Name*
Type of Account*
Bank Institution Name
Type of Account
Bank Institution Name
Type of Account
Credit Account / Loan #1*
Type of Account (Auto Loan, Visa, Etc.)*
Amount Owed/Monthly Payment*
Credit Account / Loan #2
Type of Account (Auto Loan, Visa, Etc.)
Amount Owed/Monthly Payment
Credit Account / Loan #3
Type of Account (Auto Loan, Visa, Etc.)
Amount Owed/Monthly Payment
Credit Account / Loan #4
Type of Account (Auto Loan, Visa, Etc.)
Amount Owed/Monthly Payment
Other Major Obligations

MISCELLANEOUS
Do you have pets?*
If Yes, what kind?*
(Please note Prospect Realty Syndicate, Inc. prohibits pets on premises and violating this term is grounds for eviction)
Do you smoke?*
Do you have a water-bed?*
Please answer Yes or No to the following questions:
Filed for bankruptcy?*
Optional: additional information
Been sued?*
Optional: additional information
Been evicted?*
Optional: additional information
Been convicted of a crime?*
Optional: additional information

REFERENCES AND EMERGENCY CONTACT
Personal Reference #1*
Relationship*
Address*
Street Address City State / Province / Region ZIP / Postal Code
Phone*
Personal Reference #2*
Relationship*
Address*
Street Address City State / Province / Region ZIP / Postal Code
Phone*
Personal Reference #3*
Relationship*
Address*
Street Address City State / Province / Region ZIP / Postal Code
Phone*
Contact in an Emergency*
Relationship*
Address*
Street Address City State / Province / Region ZIP / Postal Code
Phone*
Consent*
I certify that all the information given above is true and correct and understand that my lease or rental agreement may be terminated if I have made any false or incomplete statements in this application. I authorize verification of the information provided in this application from my credit sources, current and previous landlords and employers, and personal reference. In addition, by signing this application, I acknowledge that the lease terms of Prospect Realty Syndicate, Inc. (which include a 1 year lease agreement, 1 months security deposit upon signing of lease agreement when and if an apartment becomes available, and a no-pets policy), have been explained to me.
Applicant*
Date*
Date Format: MM slash DD slash YYYY

Consumer Report Disclosure Form
Prospect Realty Syndicate, Inc. may, with your consent, obtain a consumer report (as defined by the Fair Credit Reporting Act) from ACRAnet, Inc., a Consumer Reporting Agency, for your apartment rental application, and which may contain information bearing on your credit worthiness, credit standing, credit capacity, criminal background and eviction history. This may include procurement of an investigative consumer report (defined as a report that includes information as to your character, general reputation, personal characteristics, or mode of living).

You may request that the nature and scope of any investigative consumer report be disclosed to you. Such disclosure will be made within 5 days of our receipt of the request from you or five days after the date the investigative consumer report was first requested, whichever is later.

By signing below, you grant permission to Prospect Realty Syndicate, Inc. to obtain such report or reports at any time. You also grant permission to all parties to release information regarding your previous or current military service, employment, education, or criminal matters including information which may be deemed negative.
Signature (Please enter your full name)*
Date*
Date Format: MM slash DD slash YYYY
Identity Information
Name*
First Middle Last
Other Names Used
Social Security Number*
Date of Birth*
Date Format: MM slash DD slash YYYY
Current Home Address*
Street Address City State ZIP Code
Driver License*
Please list each city, county and state in which you have lived, worked or attended school in the last ten years. Use a second form if necessary to provide full disclosure.
City
County
State
City
County
State
City
County
State
City
County
State

Rental Application

Step 1 of 10

APPLICANT

ADDITIONAL OCCUPANTS

RENTAL HISTORY – PLEASE INCLUDE STREET ADDRESS, CITY, STATE AND ZIP CODE

EMPLOYMENT HISTORY

INCOME

CREDIT AND FINANCIAL INFORMATION

MISCELLANEOUS

REFERENCES AND EMERGENCY CONTACT