RK RENTAL APPLICATION
Equal Housing Opportunity
The undersigned hereby makes an application to rent the following property:
Anticipated move date of at a monthly rent of $ and security deposit of
$ .
PLEASE TELL US ABOUT YOURSELF
Full Name Home Phone ( )
Date of Birth Social Security #
Email Address: _(optional) Other Phone ( )
Co-Applicant Name Names of Dependents
Co-Applicant Date of Birth Social Security #
Dependents Date of Birth
List All Pets
PLEASE GIVE RESIDENTIAL HISTORY (LAST 3 YEARS)
Current Address Apt# City State Zip _
Month/Year Moved In Reasons for Leaving Rent $
Owner/Agent Phone ( )
Previous Address (last3years) Rent $ _
Owner/Agent Phone ( )
PLEASE DESCRIBE YOUR CREDIT HISTORY
Have you declared bankruptcy in the past seven (7)
years?
Yes No
Have you ever been evicted from a rental residence?
Yes No
Have you had two or more late rental payments in the
past year?
Yes No
Have you ever willfully or intentionally refused to pay
rent when due?
Yes No
PLEASE PROVIDE YOUR EMPLOYMENT INFORMATION
Your Status: Full Time Part Time Student Unemployed
Employer_
Dates employed Employed as__
Supervisor Name Phone ( )__
Salary $ per . (If employed by above less than 12 months, give name
& phone of previous employer or school: .)
If you have other sources of income that you would like us to consider, please list income, source,
and person (banker, employer, etc.) who we may contact for confirmation. You do not have to
reveal alimony, child support, or spouse's annual income unless you want us to consider it in this
application.
Amount $ Source/Contact
Name
PLEASE LIST YOUR REFERENCES
Banking Accounts:
Name Type of Account Account Number
Name Type of Account Account Number
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