Application For Apartment Lease

Property Name*
Applicant Name*
First Last
Co-Applicant Name
First Last
Applicant Phone Number*
Applicant Email
Current Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Landlord Name
First Last
From:
MM slash DD slash YYYY
To:
MM slash DD slash YYYY
Household Composition
List all persons who will be living in the unit including head of household. Be sure to include names, relationship, birthdate, sex & social security numbers
Name Relationship Birthdate Sex Social Security Number
Previous Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Landlord Name
First Last
Previous Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Landlord Name
First Last
HOUSEHOLD INCOME INFORMATION
Wages/Salaries*
Include overtime, tips, bonuses, commissions, self-employment etc.
Workers Compensation
Welfare/Disability Benefits

AFDC, SSI, GA
Unemployment/ Severance Pay
Child Support
Alimony
Social Security Payments
Pensions
Retirement Benefits
Death Benefits
Annuities / Life Insurance Dividends
Lump Sum Benefits

Inheritance, Insurance Settlement, Lottery, Capital Gains
Other
Please list
EMPLOYER INFORMATION
Employer Name
First Last
Phone
BANKING INFORMATION
Name of Bank*
Business name
Checking/Savings
Account Number
MISCELLANEOUS
Have you or any member of your household ever been convicted of a felony or a misdemeanor other than a traffic violation?
- Yes
- No
ALL HOUSEHOLD MEMBERS AGE 18 AND OLDER MUST ELECTRONICALLY SIGN BELOW
Name
First Last
Name
First Last
Name
First Last
INFORMED CONSENT
THE FOLLOWING NAMED INDIVIDUAL HAS MADE APPLICATION FOR HOUSING. THIS FORM IS A REQUEST TO THE ROSEAU COUNTY LAW ENFORCEMENT TO DISCLOSE ALL CRIMINAL HISTORY RECORD INFORMATION TO THE APARTMENT MANAGER FOR THE PURPOSE OF AN APPLICATION APPROVAL. ONE FORM NEEDS TO BE FILLED OUT FOR EACH RESIDENT OF THE LEASED UNIT
Name*
First Middle Last
Maiden-Alias or Former Name
First Last
Current Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Previous Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Date of Birth*
MM slash DD slash YYYY
Sex*
Social Security Number*
Driver's License Number*
Signature*
Date*
MM slash DD slash YYYY

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Application For Apartment Lease

Application For Apartment Lease

HOUSEHOLD INCOME INFORMATION

EMPLOYER INFORMATION

BANKING INFORMATION

MISCELLANEOUS

ALL HOUSEHOLD MEMBERS AGE 18 AND OLDER MUST ELECTRONICALLY SIGN BELOW

INFORMED CONSENT

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Name	Relationship	Birthdate	Sex	Social Security Number