Rental Application

The Applicant provides the following identifying and contact information:

1. Date of birth: ;

2. Social Security number or government ID number: ;

3. Driver's license or other photo ID number, and the issuing state or country: ;

4. Phone number: ;

5. Email address: ;

6. Every other person who would live at the Property, and their relationship to the Applicant: .

The Applicant is applying to rent the Property described above, with a requested move-in date of . This clause describes what the Applicant is asking for. It is not an offer the Landlord/Agent has accepted, and no rent amount, lease term or other tenancy term is agreed by this Application.

The Applicant also provides the following about the proposed household:

1. Total number of occupants proposed for the Property, including the Applicant: ;

2. Pets that would live at the Property, if any (species, breed, weight): ;

3. Vehicles to be kept at the Property, if any (make, model, license plate): .

The Applicant provides the following residence history, starting with the current address given above:

1. Current landlord's name and phone number: ;

2. Length of residence at the current address: ;

3. Reason for leaving the current address: ;

4. Previous address, if at the current address less than two years, with previous landlord and length of residence there: .

The Applicant provides the following employment and income information, to be verified as described in clause 7. The Applicant is not required to disclose income from alimony, child support or public assistance unless the Applicant chooses to have it considered in this Application.

1. Current employer's name, address and phone number: ;

2. Position and length of employment: ;

3. Gross monthly income from this employment: ;

4. Supervisor or HR contact for verification: ;

5. Additional income source and monthly amount, if any: .

The Applicant provides the following references, who the Landlord/Agent may contact as described in clause 7:

1. Personal reference's name and phone number: ;

2. Second personal reference's name and phone number: ;

3. Prior landlord reference, if not already given in clause 3: .

. Where a fee applies, the Applicant shall pay an application fee of , which covers the actual or average cost of obtaining the credit report, background check and reference verification described in clause 7. This fee is not a security deposit, is not rent, and is not a credit toward any future deposit or rent.

The Applicant acknowledges that this fee is non-refundable once the Landlord/Agent has ordered the reports described in clause 7, whether or not the Application is approved, except to the extent applicable local law requires a refund or caps the amount of this fee. Check the application-fee limit and refund rule that applies where the Property is located before setting this figure — several states and cities cap the amount, require a receipt, or require a refund of any unused portion.

By signing this Application, the Applicant authorizes the Landlord/Agent, and any screening company the Landlord/Agent uses, to do the following for the purpose of evaluating this Application:

1. obtain a consumer credit report and credit score from one or more consumer reporting agencies;

2. obtain a criminal background check, sex-offender registry check, and eviction or court-record history, to the extent applicable law permits;

3. verify the employment, income and residence history given above by contacting the employers, landlords and references named;

4. contact the personal references named above; and

5. share the results of the above with any co-applicant, guarantor or property owner involved in the same tenancy decision.

The Applicant understands that if the Landlord/Agent denies this Application, or offers less favorable terms, based in whole or in part on information in a consumer report, applicable law — such as the U.S. Fair Credit Reporting Act and similar consumer-reporting laws elsewhere — may require the Landlord/Agent to give the Applicant an adverse-action notice identifying the consumer reporting agency used and stating the Applicant's right to obtain a free copy of the report from that agency and to dispute inaccurate information in it. The consent given in clause 7 does not waive any right the Applicant has under that law.

That consent is limited to evaluating this Application for the tenancy described above and expires . The Landlord/Agent will not use a report obtained under that consent for any other purpose.

The Landlord/Agent will consider this Application without regard to race, color, religion, sex, national origin, familial status, or disability, and without regard to any further characteristic that the fair-housing law applying to the Property protects — some states and cities also protect source of income, sexual orientation, gender identity or marital status, so check the law where the Property is located. Any further protected characteristic that law adds: .

The screening standards described in clause 7 will be applied the same way to every applicant for the Property.

The Applicant certifies that every statement made in this Application is true, complete and accurate to the best of the Applicant's knowledge, and understands that the Landlord/Agent is relying on it in deciding whether to offer a tenancy. The Applicant shall promptly tell the Landlord/Agent in writing of any material change to this information before the Application is decided.

The Applicant understands that a false or materially misleading statement in this Application is grounds for the Landlord/Agent to deny it and — if discovered after a lease is signed — may be grounds for the Landlord to terminate the resulting tenancy, to the extent applicable law and that lease allow.

Submitting this Application, paying any fee under clause 6, or being screened under clause 7 does not create a tenancy, a right to occupy the Property, or any obligation on the Landlord/Agent to offer one. A tenancy exists only once the Landlord and the Applicant sign a separate written lease or rental agreement stating the rent, term and other conditions of the tenancy.

This Application is governed by the laws of , including any state or local law governing application fees, consumer reports and fair housing that applies where the Property is located. The Landlord/Agent will retain and dispose of this Application in accordance with that law.