Rental Application
Date	Initial if over 18 year of age		Social Security No.
Name of Applicant	Hm Phone	Cell phone	email
Street Address	City	State	Zip Code
Current Landlord Name	Landlord Address, City, State		Landlord Phone No.
Previous Landlord Name	Address, City, & State		Phone No.
Name Current School Enrolled	Major	Program Length	Year of Graduation	Masters?
				Phd?
Current Employer	Co. Address, City, State		Co. Phone No.
Position	Business Type	Salary/Year	How Long in this Job?
Previous Employer	Address, City, State		Phone No.
			How Long in this Job?
Reference	Address, City, State		Phone No.
Name of Family or Kin for emergency		How are they related to you?
Address, City, State, Country			Phone No.
Credit Card Name
Name of Bank where accounts are held
Are you a convicted felon? Yes / No		Signature
FOR OFFICE USE ONLY
Apartment No.	No. occupants? Adults Children		Base Monthly Rent
Address, City, State	Pets?	Ages of minor children	First Month
			Last Month
Months of Lease?	Start Lease	Lease expires	Security Deposit
			Key Deposit
Renting Agent			Total
			Balance Due
Pursuant to State and Federal Law, the management shall not make an inquiry concerning race, religion, color, national origin, sex, sexual orientation, age (except if a minor), ancestry, or marital status of the applicant or veteran status, military service, or handicapped. The applicant authorizes the management and renting agency to obtain a consumer credit report. The applicant warrants and represents that all statements herein are true and accurate and agrees to execute a standard form apartment lease or tenancy at will agreement, a copy of which the applicant has had an opportunity to examine, which the Lessor may choose to terminate if statements made herein are untrue. Deposits will be applied as shown above, or applied as damages sustained by the owner except if the application is not accepted by the owner. The renting agent is an independent contractor and has no authority to make any representations concerning the premises; The renting agent is only authorized to show the apartment for rent and assist in screening applicants. Rolls Realty Inc. provides equal housing opportunity.