Rental Application
Date: _______________ Preferred Move-In Date: ____________
Rental Unit Applied For: _________________________________________________
Rent per month: $____________ Security Deposit: $_________________
Personal Information
Name: ____________________________________ Phone No. __________________
Social Security No.___-___-___ Drivers License No.________________State________
Birth date: ____/_____/_____Number of people in unit: Adults:____Children:________
Current Address:________________________________________________________
City________________________________, State_____________ Zip____________
Landlord_______________________________________Phone #________________
Best time to contact:______________________How long at present address:__________
Reason for leaving: ____________________________________________________
Prior address: ________________________________________________________
City________________________________, State_____________ Zip___________
Landlord__________________________Phone #____________________________
Best time to contact:______________________How long at prior address:____________
Reason for leaving: ____________________________________________________
Employer/Source of Income:_______________________Position: _________________
How long: ________________________Monthly Income: $_____________________
Person to contact: _________________________Work phone:__ _________________
Other Occupants of Unit (All non-married adults must fill out separate applications.)
1.______________________ 2.___________________________
3.______________________ 4.___________________________
5.______________________ 6.___________________________
Not all properties allow pets, and written
permission must be given by Heritage in order to have a pet. Heritage Property Management
has a non-refundable, non-negotiable pet fee that may vary by property.
The pet policy may change at any time at Heritage’s discretion.
Number of pets:_______
Type of pet:___________________
Name of Bank: ___________________________Telephone: ___________________
Address/Branch: _____________________City_____________State/Zip_________
Emergency Contact Information
Name: __________________________________Relationship: _________________
Address_____________________________________________________________
City__________________________________State/Zip______________________
Telephone No.______________________Work Telephone No._________________
Personal Reference
Name:___________________________________Relationship:_________________
Address_______________________________Telephone No.__________________
Other Information
Answer yes or no to the following questions:
HAVE YOU EVER:
Been arrested and/or convicted for any reason concerning illegal drugs/alcohol? _____
Been arrested and/or convicted of or pleaded guilty or "no contest" to a
felony? (Whether or not resulting in a conviction)? _____
Been arrested and/or convicted of or pleaded guilty or "no contest" to a
misdemeanor involving sexual misconduct (whether or not resulting in a conviction)? _____
If yes to any of the above questions, please describe: ______________________________
__________________________________________________________________________
Filed for bankruptcy?_____If yes, when?______________________________________
Been served an eviction notice or been asked to vacate a property you were renting?
_____
Willfully or intentionally refused to pay rent when due? _____ If yes, please describe:
_____
____________________________________________________________________
Have you given your landlord thirty days written notice? _____
How were you referred to us? Newspaper (name)________________________________
Realtor (name)_______________________Other _____________________________
Do you have a waterbed? _____