HOUSE RENTAL APPLICATION
The undersigned hereby makes this application to:
Property Owner ►
City & State ►
to rent a _________________ bedroom house for a lease term of ________________________________________________ months,
commencing on _________________________________, 2________, at a monthly rental of $______________________________________________.
HOUSE OCCUPANTS:
APPLICANT:
Full Name: _______________________________________________________________________________________________________________
First |
Middle |
Last |
Social Security Number: _________________________________________ |
Date of Birth: ________________________________________ |
CO-APPLICANT:
Full Name: _____________________________________________________________________________________________________________
First |
Middle |
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Social Security Number: |
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Date of Birth: __________________________________ |
OTHER OCCUPANTS: |
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Name: _______________________________ DOB: ________________ |
SS#: ______________________ Relationship: |
___________________ |
Name: _______________________________ DOB: ________________ |
SS#: ______________________ Relationship: |
___________________ |
Name: _______________________________ DOB: ________________ |
SS#: ______________________ Relationship: |
___________________ |
APPLICANT MARITAL STATUS: |
Single ________ |
Married ________ |
Separated _______ Divorced |
_______ |
CURRENT / PREVIOUS ADDRESSES: |
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Have you ever lived in an apartment community or house managed by Lindsey Management Co., Inc.? Yes______ |
No_______ |
If yes, which apartment or what house address? Apt. Name/House Address______________________________________ |
City_________________________ State____________ When? |
_________________ |
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CURRENT ADDRESS: |
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Rent: $ |
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How Long: ________________________ |
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Street Address |
Apt. # |
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Landlord Name: |
____________________________________________ |
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City |
Zip Code (Required) |
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Landlord Phone: |
____________________________________________ |
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Phone |
Date Moved Out |
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_______________________________________________________________________________________________________________
Reason for Moving
Lindsey Management Company, Inc.-Homes Division |
HD-1101—07.14.11 |
PREVIOUS ADDRESS (if at current address for less than 2 Years):
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Rent: $ |
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How Long: __________________________________ |
Street Address |
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Apt. # |
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Landlord Name: |
City |
Zip Code (Required) |
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___________________________________________________________ |
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Landlord Phone: |
Phone |
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Date Moved Out |
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________________________________________________________________________________________________________________
Reason for Moving
IN CASE OF EMERGENCY NOTIFY: |
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____________________________________________________ |
Name |
Phone |
________________________________________________ |
____________________________________________________ |
Address |
Relationship |
CURRENT EMPLOYMENT/INCOME:
___________________________________________________________________________________________________________________
Applicant's EmployerAddressHow Long?Phone
___________________________________________________________________________________________________________________
Gross Monthly SalaryAdditional Monthly Income (if any) Source
___________________________________________________________________________________________________________________
Co-Applicant's EmployerAddressHow Long?Phone
___________________________________________________________________________________________________
Gross Monthly SalaryAdditional Monthly Income (if any) Source
REFERENCES:
BANK(S):
Checking Account: ___________________________________________________________________________________________________
Bank NamePhoneAddressCity/State/Zip
Savings Account: __________________________________________________________________________________________________
Bank NamePhoneAddressCity/State/Zip
CREDIT:
_____________________________________________________________________________________________________________________
NamePhoneAddressCity/State/ZipType of Credit
_____________________________________________________________________________________________________________________
Name |
Phone |
Address |
City/State/Zip |
Type of Credit |
PERSONAL: |
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____________________________________________________________________________________________________________________
NamePhoneAddressCity/State/ZipRelationship
____________________________________________________________________________________________________________________
Name |
Phone |
Address |
City/State/Zip |
Relationship |
VEHICLES: |
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Applicant Driver's License #: |
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State: |
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Expires: |
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Vehicle #1 Model: |
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License #: |
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State: |
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Applicant Driver's License #: |
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State: |
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Expires: |
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Vehicle #2 Model: |
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License #: |
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State: |
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Lindsey Management Company, Inc.-Homes Division |
HD-1101—07.14.11 |

CREDIT/CRIMINAL: I hereby consent to allow Property Owner and/or its designated agents and employees, to obtain a consumer credit report and criminal record information for the purpose of determining whether to lease a house to me. I also agree and understand that Owner and/or its agents and employees may obtain additional consumer credit reports and criminal record reports on me in the future to update or review my account. Upon my request, Owner and/or its agents or employees will tell me whether consumer credit reports or criminal record reports were requested and the names and addresses of any consumer reporting agency that provided such reports.
INSURANCE: Neither the Owner nor its designated agents or representatives carry insurance on the personal property of residents or other occupants. It is recommended that residents obtain insurance coverage.
APPLICATION FEE (nonrefundable). The application fee delivered by Applicant(s) to the Owner and/or its designated agent or representative in the amount indicated below is to defray the cost of administrative paperwork and is nonrefundable.
APPLICATION DEPOSIT (may or may not be refundable). In addition to the application fee, Applicant(s) has delivered to the Owner or its designated agent or representative an application deposit in the amount indicated below. The application deposit is not a security deposit. However, it will be credited toward the required security deposit when the contemplated House or Townhouse Lease Contract has been signed by all parties; OR it will be refunded if Applicant or any Co-Applicant is disapproved; OR it will be retained as liquidated damages if: 1) Applicant or any Co-Applicant is notified of approval and fails to sign the contemplated House or Townhouse Lease Contract within 24 hours of having received notification of approval from Owner or its agents or employees, or 2) decides not to rent the house for any reason after approval.
RECEIPT. Application fee (nonrefundable): |
$ 20.00 |
Application deposit (may or may not be refundable): $_______________
Total of above application fee and application deposit: $______________
MANAGER AND STAFF REPRESENT OWNER: Applicant(s) agree and understand that the Manager and all staff and employees of Owner represent the Owner exclusively in the house application and leasing process. Applicant(s) further understand that they may, at their own expense, select an agent or agents to represent them in the house application and leasing process.
VERIFICATION: I represent that all of the information in this House Rental Application is true and accurate to the best of my knowledge, and I acknowledge that Owner and its agents or representatives will rely on this information in considering this application. All persons and/or firms named above may freely give any requested information concerning me, and I hereby waive all right of action for any consequence resulting from such information. In the event that any of the foregoing information is discovered to be false, I waive any rights that I may have under applicable law to notice or the establishment of grounds for eviction and grant Owner or its agents or representatives the unconditional right to cancel my lease and immediately cause my eviction without prior notice or the establishment of grounds for eviction.
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LINDSEY MANAGEMENT CO., INC., Agent |
Applicant |
Date |
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Applicant |
Date |
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CERTIFICATION: For the purpose of allowing Owner or Owner’s Agent or Representative to evaluate my application and determine my suitability as a resident, I hereby certify that neither I nor any potential occupants of my home have ever been charged with or convicted of a felony or any crime involving theft, violence, fraud, illegal drugs, or a sexual offense of any kind whatsoever.
___________________________________________________________ |
____________________________________________________ |
Applicant |
Date |
Applicant |
Date |
We do business in accordance with the Federal Fair Housing Law.
FOR OFFICE USE ONLY: IF APPLICATION ACCEPTED
_______________________________________________________________________________________________________________________
Address |
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Apt. No. |
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Telephone |
$ |
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$ |
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Application Fee Amount |
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Move-In Date |
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Lease Expiration Date |
Application Deposit Amount |
Rent Paid at Move-in |
Lindsey Management Company, Inc.-Homes Division |
HD-1101—07.14.11 |