Realty Solutions Management
90 E. College Ave.
Westerville, OH 43081
Ph 794-2222 Fax 890-8833
RESIDENTIAL RENTAL APPLICATION
Property Location __________________________________
Date ________________________________
CONDITIONS OF OCCUPANCY
Utilities Paid by Renter:
Gas___ Electric___
Water___ Sewer___
Refuse___ Other___
TO BE COMPLETED BY APPLICANT
(Please Print Clearly)
1. Applicant’s Name
___________________________________________
Phone _____________________
Social Security
Number____________________________
Date of Birth
_________________________
2. Spouse’s Name _____________________________________________
Phone______________________
Social Security Number____________________________
Date of Birth __________________________
3. Present
Address____________________________________________________________
City_______________________________
State____________ Zip_____________
4. Present
Landlord__________________________
Phone________________
How Long There?________
Monthly Rent____________________
Reason For Leaving__________________________________
5. Previous
Landlord___________________________________________
Phone______________________
Monthly Rent____________________
Reason For Leaving______________________________________
4. Full names of all individuals (and ages of children) who will be
occupying premises:
_____________________________________________________________________________________________________________
5.
Pets(specify)_____________________________________________________________________
6. Have you ever been evicted, sued for
nonpayment of rent, or breached a lease (if so,
explain)?_____________________________________________________________________________________________________
7. Present
Employer____________________________________________
Phone______________________
Address
______________________________________
Occupation ______________________________
Gross Monthly Salary _______________________
Length of Employment _________________________
8. Previous
Employer___________________________________________
Phone______________________
Address_______________________________________
Occupation______________________________
Gross Monthly Salary________________________
Length of Employment__________________________
9. Spouse
Employer____________________________________________
Phone______________________
Address_______________________________________
Occupation______________________________
Gross Monthly
Salary________________________
Length of Employment_________________________
10. Other Income, if any (specify
source)___________________________________________________________
I certify that the above information is true and complete. I authorize
the verification of this information by contacting any or all individuals,
police records and financial institutions listed above. I understand that
this is not a lease or an offer to rent. No binding obligation of any
kind exists between the owner and myself unless and until a lease is
signed. This Application is subject to prior Applications. This
Application shall remain the property of the owner.
A payment of $____________ is included herewith, which payment is made for the
purpose of verifying the information included on this application. I
understand this charge is not under any circumstances, to be returned to me.
Signature of Applicant______________________________________
Date____________________
Spouse________________________________________
Date____________________
NO PERSON SHALL BE DENIED THE RIGHT TO RENT OUR PROPERTY BECAUSE OF THEIR RACE,
COLOR, RELIGION, SEX, NATIONAL ORIGIN OR ANCESTRY.