Visit www.RentPrep.com or call us at 1-888-877-8501
APPLICATION FOR RENTAL
Notice: All adult applicants (18 years or older) must complete a separate application for rental.
APARTMENT
RENT
START DATE
AGENT/REFERRED BY
APPLICANT INFORMATION
LAST NAME FIRST NAME M.I.
SSN
DRIVER'S LICENSE #
BIRTH DATE
HOME PHONE
( )
WORK PHONE
( )
EMAIL
CURRENT ADDRESS
STREET ADDRESS CITY STATE ZIP
DATE IN
DATE OUT
LANDLORD PHONE
( )
MONTHLY RENT
$
REASON FOR LEAVING
PREVIOUS ADDRESS
STREET ADDRESS CITY STATE ZIP
DATE IN
DATE OUT
LANDLORD PHONE
( )
MONTHLY RENT
$
REASON FOR LEAVING
OTHER OCCUPANTS
LIST NAMES AND BIRTH DATES OF ALL ADDITIONAL OCCUPANTS 18 YEARS OR OLDER
LIST NAMES AND BIRTH DATES OF ALL OCCUPANTS 18 YEARS OR YOUNGER
PETS
PETS?
DESCRIBE
EMPLOYMENT & INCOME INFORMATION
1. OCCUPATION
MONTHLY SALARY
$
SUPERVISOR NAME
SUPERVISOR PHONE
( )
START DATE
END DATE
2. OCCUPATION
MONTHLY SALARY
$
SUPERVISOR NAME
SUPERVISOR PHONE
( )
START DATE
END DATE
1. OTHER INCOME DESCRIPTION
MONTHLY INCOME
$
2. OTHER INCOME DESCRIPTION
MONTHLY INCOME
$
EMERGENCY CONTACT
1. NAME
ADDRESS
PHONE
( )
RELATIONSHIP
2. NAME
ADDRESS
PHONE
( )
RELATIONSHIP
PERSONAL REFERENCES
1. NAME
ADDRESS
PHONE
( )
RELATIONSHIP
2. NAME
ADDRESS
PHONE
( )
RELATIONSHIP
RentPrep Tenant Screening Visit www.RentPrep.com or call us at 1-888-877-8501
BACKGROUND INFORMATION
HAVE YOU EVER:
Filed for bankruptcy?
Willfully or intentionally refused to pay rent when due?
Been evicted from a tenancy or left owing money? If yes, please provide Property Name, City, State, and Landlord Name.
Yes No
Been convicted of a crime? If yes, please provide Type of Offense, County, and State.
Yes No
VEHICLE INFORMATION
1. MAKE & MODEL
YEAR
LICENSE NO. & STATE
2. MAKE & MODEL
YEAR
LICENSE NO. & STATE
OTHER VEHICLES
OTHER INFORMATION
HOW DID YOU HEAR ABOUT THIS PROPERTY?
PLEASE INCLUDE ANY OTHER INFORMATION YOU BELIEVE WOULD HELP TO EVALUATE THIS APPLICATION
I/we, the undersigned, authorize Fidelis Screening Solutions, LLC, Landlord and its agents to obtain an investigative consumer
credit report including but not limited to credit history, OFAC search, landlord/tenant court record search, criminal record
search and registered sex offender search. I authorize the release of information from previous or current landlords,
employers, and bank representatives. This investigation is for resident screening purposes only, and is strictly confidential.
This report contains information compiled from sources believed to be reliable, but the accuracy of which cannot be
guaranteed. I hereby hold Fidelis Screening Solutions, LLC, Landlord and its agents free and harmless of any liability for any
damages arising out of any improper use of this information.
Important information about your rights under the Fair Credit reporting Act:
You have a right to request disclosure of the nature and scope of the investigation.
You must be told if information in your file has been used against you.
You have a right to know what is in your file, and this disclosure may be free.
You have the right to ask for a credit score (there may be a fee for this service).
You have the right to dispute incomplete or inaccurate information. Consumer reporting agencies must correct
inaccurate, incomplete, or unverifiable information.
These reports are being processed by Fidelis Screening Solutions, LLC, 4534 Clinton St. Ste. 2, West Seneca, NY 14224.
A summary of your rights under the Fair Credit Reporting Act is available by visiting (Para information en espanol, visite o
escribe): http://www.consumerfinance.gov/learnmore or writing Consumer Financial Protection Bureau, 1700 G Street N.W.,
Washington, DC 20552
Applicant agrees to pay a non-refundable application fee of: $___________
(Signed/Applicant) Date