Residential Rental Application

Application for Rental

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Property you are completing application for *

Name *

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Email *

Start Date Requested *

Current Address *

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Date of Birth *

Driver's License # *

Social Security Number *

Other Occupants

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Name *

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Name *

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List Additional Occupants *

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Employment & Income Information

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Monthly Salary *

Employer/Company *

Occupation *

Supervisor Name *

Supervisor Phone Number *

Employment Start Date *

Emergency Contact

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Name *

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Personal References

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Name *

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Relationship *

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Have you Ever....

Background Information

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 *

Been convicted of a crime? *

If yes, please provide Type of Offense, County and State *

Vehicle Information

Make & Model *

Make Model *

Year *

License No. & State *

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 Elajenta, 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 back 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 Elajenta,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 the 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.

In connection with my application for housing, I understand that the property owner/agent may obtain one or more consumer reports, which may contain public information, for the purposes of evaluating my application. These consumer reports will be obtained from one or more of the follow consumer reporting agencies:

Equifax, E.C.I.F., P.O. Box 740241, Atlanta, GA, 30374-0241, (800) 685-1111
Trans Union, Regional Disclosure Center, 1561 Orangethorpe Ave., Fullerton, CA, 92631, (714) 738-3800
Experian (TRW), Consumer Assistance, P.O. Box 949, Allen, TX, 75002, (888) 397-3742
On-Site Manager, Inc., P.O. Box 1514, Los Altos, CA, 94023-1514, (877) 222-0384

TERMS OF ACCEPTANCE AND SIGNATURE

I, the applicant for this application warrant the truthfulness of the information provided in this application. Please type your First and Last Name below to electronically sign document.

Electronic Signature *

Acceptance *

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.

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