Rental Application Form

See a rental you like?

Fill out the application below or Download our mail-in application. Please provide complete names and phone numbers. Do not list references twice. When possible, avoid giving family members as references. More complete information will result in a better chance of approval.

Rental Property Interested

Anticipated Move Date:

Rental Address:

(If applying for more than one location, please put the addresses in the "Additional Information" section)

Anticipated Rent:

Applicant Information

Name:

Birth Date:

Phone #:

Email:

Tell us about yourself and any special requirements you have

(Special Requirements, etc.):

Characters: (300 remaining)

Co-applicant Information

Name:

Birth Date:

Phone #:

Email:

Tell us about yourself and any special requirements you have

(Special Requirements, etc.):

Characters: (300 remaining)

Inhabitants

Occupants

Name	Age	Relationship

Animals

Type	Breed	Weight	Age

Disclaimer: Failure to disclose animals may affect your ability to be approved.

Residential Information (Last 3 Years)

Applicant Current Residence

Date Lived:

Current Address:

City:

State:

Zip:

Owner / Agent:

Owner Phone #:

Monthly Rent:

Reason for Leaving:

Characters: (300 remaining)

Co-applicant Current Residence

Date Lived:

Current Address:

City:

State:

Zip:

Owner / Agent:

Owner Phone #:

Monthly Rent:

Reason for Leaving:

Characters: (300 remaining)

Applicant Past Residence

Date Lived:

Past Address:

City:

State:

Zip:

Owner / Agent:

Owner Phone #:

Monthly Rent:

Reason for Leaving:

Characters: (300 remaining)

Co-applicant Past Residence

Date Lived:

Past Address:

City:

State:

Zip:

Owner / Agent:

Owner Phone #:

Monthly Rent:

Reason for Leaving:

Characters: (300 remaining)

References

FAMILY MEMBERS SHOULD NOT BE USED AS REFERENCES. Who makes a good reference? Co-workers, people you have a history of business with, Pastors, etc. Try to put down people who know you well enough that they could provide a character reference for you.

Reference 1:

Name:
Address:
Phone:
Relationship:

Reference 2:

Name:
Address:
Phone:
Relationship:

Reference 3:

Name:
Address:
Phone:
Relationship:

Additional Information:

Please give any additional information that might help the owner and/or management evaluate this application

(Phone number and best time of day to reach you, criminal history, past rental issues, etc.):

Characters: (300 remaining)

I hereby state that all information entered in this form is truthful and correct and recognize by clicking "Submit" that Rubey Realty/Rentals will need to obtain more confidential information such as social security numbers, banking information, and driver’s license numbers to complete and finalize the application process.

I recognize that as part of your procedure for processing my application, an investigative consumer report may be prepared whereby information is obtained through personal interviews with others with whom I may be acquainted. This inquiry includes information as to my character, general reputation, personal characteristics and mode of living.

Have you declared bankruptcy in the past 7 years?	Yes:	No:
Have you ever been evicted from a rental residence?	Yes:	No:
Have you had two or more late rental payments in the past year?	Yes:	No:
Have you ever willfully or intentionally refused to pay rent when due?	Yes:	No:
Please Explain Any of the "Yes" Responses Above:
Characters: (300 remaining)

Have you declared bankruptcy in the past 7 years?	Yes:	No:
Have you ever been evicted from a rental residence?	Yes:	No:
Have you had two or more late rental payments in the past year?	Yes:	No:
Have you ever willfully or intentionally refused to pay rent when due?	Yes:	No:
Please Explain Any of the "Yes" Responses Above:
Characters: (300 remaining)

Dates Employed?	to
Employment Status?	Full Time Part Time Student Unemployed
Company?
Position?
Supervisor Name?
Supervisor Phone?
Salary Amount?	Per:

Dates Employed?	to
Past Employment?	Full Time Part Time Student Unemployed
Company?
Position?
Supervisor Name?
Supervisor Phone?
Salary Amount?	Per:

Dates Employed?	to
Co-Applicant Employment Status?	Full Time Part Time Student Unemployed
Company?
Position?
Supervisor Name?
Supervisor Phone?
Salary Amount?	Per:

Rental Application Form

See a rental you like?

Rental Property Interested

Applicant Information

Co-applicant Information

Inhabitants

Occupants

Animals

Residential Information (Last 3 Years)

Applicant Current Residence

Co-applicant Current Residence

Applicant Past Residence

Co-applicant Past Residence

History

Applicant History

Co-applicant History

Employment Information:

Applicant Current Employment

Applicant Past Employment

Co-applicant Current Employment

Co-applicant Past Employment

References

Additional Information:

I agree the above information, to the best of my knowledge, is true and correct.

I hereby authorize you to release my information regarding my tenancy to the inquiring landlord.

Please wait, submitting...

Dates Employed?	to
Co-Applicant Past Employment?	Full Time Part Time Student Unemployed
Company?
Position?
Supervisor Name?
Supervisor Phone?
Salary Amount?	Per: