This form contains 124 fields organized into 22 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Animal Information
Animal Age Text
Provide the age of the animal.
Check Box11 CheckBox
Check Box9 CheckBox
Applicant Current Address
Applicant Current Address Line 1 Text
Enter the first line of your current home address, including street number and street name.
Applicant Current Address Line 2 Text
Enter the second line of your current home address, such as apartment, unit, or suite number.
Applicant Current Address City/State/Zip Text
Enter the city, state, and zip code of your current home address.
Applicant Current Phone Area Code Text
Enter the area code for your current phone number.
Applicant Current Phone Number Text
Enter the main part of your current phone number.
Applicant Current Monthly Rent Number
Enter your current monthly rent amount.
Applicant Current Dwelling Name Text
Enter the name of the dwelling where you currently live, if applicable.
Applicant Current Owner/Manager Name Text
Enter the name of your current dwelling's owner or manager.
Applicant Current Owner/Manager Phone Text
Enter the phone number of your current dwelling's owner or manager.
Applicant Move-in Date Date
Enter the date you moved into your current residence.
Applicant Reason for Leaving Current Residence Text
Explain why you are leaving your current residence.
Applicant Reason for Leaving Current Residence (Continued) Text
Provide additional details explaining why you are leaving your current residence.
Applicant Information
Previous Names Years Count Text
Enter the number of years for which you are listing previous names or aliases.
exactly as on driver's license or govt. ID card Text
Applicant Street Address Line 2 Text
Enter the second line of your street address, such as apartment, unit, or suite number, as shown on your driver's license or government-issued ID card.
Applicant Street Address Line 1 Text
Enter the first line of your street address as shown on your driver's license or government-issued ID card.
Driver's License Number and State Text
Enter your driver's license number followed by the issuing state.
Government Photo ID Card Number Text
Enter your government-issued photo ID card number if you do not have a driver's license.
Previous Names and Aliases Text
List any previous names or aliases you have used within the specified number of years.
Applicant Social Security Number Text
Enter your full Social Security Number.
Applicant Birthdate Date
Enter your birthdate.
Applicant Email Address Text
Enter your current email address.
Applicant Previous Address
Previous Street Address Text
Please provide the street address of your previous home.
Previous Street Address Line 2 Text
Please provide any additional street address details for your previous home, such as apartment or unit number.
Previous City, State, Zip Text
Please provide the city, state, and zip code of your previous home.
Previous Dwelling Name Text
Please provide the name of the dwelling where you previously resided.
Previous Owner or Manager Name Text
Please provide the full name of the owner or manager of your previous dwelling.
Previous Owner or Manager Phone Text
Please provide the phone number of the owner or manager of your previous dwelling.
Previous Monthly Rent Number
Please provide the monthly rent amount you paid at your previous dwelling.
Previous Move-in Date Date
Please provide the date you moved into your previous dwelling.
Previous Move-out Date Date
Please provide the date you moved out of your previous dwelling.
Credit History
Check Box19 CheckBox
Check Box20 CheckBox
Bank 1 Name, City, State Text
Enter the name of your bank, its city, and its state for the first bank account.
Bank 2 Name, City, State Text
Enter the name of your bank, its city, and its state for the second bank account.
Major Credit Card 1 Text
List the first major credit card you possess.
Major Credit Card 2 Text
List the second major credit card you possess.
Date of Application
Date of Application Date
Please enter the date when this application was filled out.
Emergency Contact Information
Emergency Contact Name Text
Enter the full name of the emergency contact person.
Emergency Contact Address Text
Enter the street address of the emergency contact person.
Emergency Contact City State Zip Text
Enter the city, state, and zip code of the emergency contact person.
Emergency Contact Work Phone Area Code Text
Enter the area code for the emergency contact's work phone number.
Emergency Contact Work Phone Number Text
Enter the remaining digits of the emergency contact's work phone number.
Emergency Contact Home Phone Area Code Text
Enter the area code for the emergency contact's home phone number.
Emergency Contact Home Phone Number Text
Enter the remaining digits of the emergency contact's home phone number.
Emergency Contact Relationship Text
Enter the relationship of the emergency contact person to you.
Emergency Dwelling Access Authorization
Check Box21 CheckBox
Check Box22 CheckBox
First Other Occupant
First Other Occupant's Name Text
Provide the full name of the first other occupant.
First Other Occupant's DL or Govt. ID Card Number Text
Enter the driver's license number or government ID card number for the first other occupant.
First Other Occupant's Birthdate Date
Enter the birthdate of the first other occupant.
First Other Occupant's Social Security Number Text
Provide the Social Security number of the first other occupant.
First Vehicle
First Vehicle Make and Color Text
Enter the make and color of the first vehicle.
First Vehicle Year Text
Enter the manufacturing year of the first vehicle.
First Vehicle License Number Text
Enter the license plate number of the first vehicle.
First Vehicle License State Text
Enter the state where the first vehicle's license plate was issued.
General
Ever Evicted or Asked to Move Out Checkbox
Check this box if you or any occupant listed in this Application has ever been evicted or asked to move out.
Ever Sued for Rent Checkbox
Check this box if you or any occupant listed in this Application has ever been sued for rent.
Other Financial Resources
Other Financial Resource 1 Text
Provide details for the first other financial resource or income to be considered.
Other Financial Resource 2 Text
Provide details for the second other financial resource or income to be considered.
Other Financial Resource 3 Text
Provide details for the third other financial resource or income to be considered.
Page 2
Doctor's Name Text
Enter the full name of the doctor to be notified in case of serious illness or injury.
Doctor's Phone Number 1 Text
Enter the first part of the doctor's phone number, typically the area code.
Doctor's Phone Number 2 Text
Enter the second part of the doctor's phone number.
Date Date
Enter the current date.
Page 5
Applicant 1 Signature Date Date
Enter the date when the first applicant signed the form.
Applicant 2 Signature Date Date
Enter the date when the second applicant signed the form.
Present Employment Information
Present Employer Text
Enter the name of your current employer.
Employer Address Text
Enter the full street address of your current employer.
Employer City, State, Zip Text
Enter the city, state, and zip code of your current employer.
Work Phone Area Code Text
Enter the area code for your work phone number.
Work Phone Number Text
Enter the main part of your work phone number.
Position Text
Enter your job position or title at your current employer.
Gross Annual Income Number
Enter your gross annual income.
Job Start Date Date
Enter the date you began your current job.
Supervisor's Name and Phone Text
Enter your supervisor's full name and their phone number.
Previous Employment Information
Previous Employer 1 Name Text
Enter the name of your previous employer.
Previous Employer 1 Address Text
Enter the street address of your previous employer.
Previous Employer 1 City, State, Zip Text
Enter the city, state, and zip code of your previous employer.
Previous Employer 1 Work Phone Area Code Text
Enter the area code for your previous employer's work phone number.
Previous Employer 1 Work Phone Number Text
Enter the remaining digits of your previous employer's work phone number.
Previous Employer 1 Position Text
Enter your job title or position held at your previous employer.
Previous Employer 1 Gross Annual Income Number
Enter your gross annual income from this previous employment.
Previous Employer 1 Employment Dates Text
Enter the start and end dates of your employment with this previous employer.
Previous Employer 1 Supervisor Name and Phone Text
Enter the name and phone number of your supervisor at this previous employer.
Referral Information
Referral_RentalPublication Checkbox
Check this box if you were referred by a rental publication.
Referral Rental Publication Name Text
Please enter the name of the rental publication that referred you.
Referral_RentalAgencyOrLocatorService Checkbox
Check this box if you were referred by a rental agency or locator service.
Referral Rental Agency/Locator Service Name Text
Please enter the name of the rental agency or locator service that referred you.
Referral Agent's Name Text
Please enter the name of the agent who referred you from the rental agency or locator service.
Referral_Friend Checkbox
Check this box if you were referred by a friend.
Referral_Newspaper Checkbox
Check this box if you were referred by a newspaper.
Referral Friend's Name Text
Please enter the name of the friend who referred you.
Referral Newspaper Name Text
Please enter the name of the newspaper that referred you.
Referral_Other Checkbox
Check this box if you were referred by a method not listed above.
Referral Other Source Text
Please enter the name of the other referral source not listed above.
Check Box18 CheckBox
Rental/Criminal History Details
Declared Bankruptcy Checkbox
Check this box if you or any occupant listed in this Application have declared bankruptcy.
Broken Rental Agreement Checkbox
Check this box if you or any occupant listed in this Application have broken a rental agreement.
Sued for Rent Checkbox
Check this box if you or any occupant listed in this Application have been sued for rent.
Sued for Property Damage Checkbox
Check this box if you or any occupant listed in this Application have been sued for property damage.
Felony 1 Details Text
Provide the year, location, and type of the first felony conviction.
Felony 2 Details Text
Provide the year, location, and type of the second felony conviction.
Felony 3 Details Text
Provide the year, location, and type of the third felony conviction.
Felony 4 Details Text
Provide the year, location, and type of the fourth felony conviction.
Check Box8 CheckBox
Check Box7 CheckBox
Second Other Occupant
Second Other Occupant Name Text
Provide the full name of the second other occupant.
Second Other Occupant DL/Govt ID Card # Text
Enter the driver's license or government ID card number for the second other occupant.
Second Other Occupant Birthdate Date
Provide the birthdate of the second other occupant.
Second Other Occupant Social Security # Text
Enter the Social Security Number for the second other occupant.
Second Vehicle
Second Vehicle Make and Color Text
Please enter the make and color of the second vehicle.
Second Vehicle Year Text
Please enter the year of the second vehicle.
Second Vehicle License Number Text
Please enter the license number for the second vehicle.
Second Vehicle State Text
Please enter the state where the second vehicle is registered.
Smoking Information
Smoking: Yes Checkbox
Check this box if you or any occupant smoke.
Smoking: No Checkbox
Check this box if neither you nor any occupant smoke.
Third Other Occupant
Third Other Occupant Name Text
Enter the full name of the third other occupant.
Third Other Occupant DL or Govt. ID Card Number Text
Enter the driver's license number or government-issued ID card number for the third other occupant.
Third Other Occupant Birthdate Date
Enter the birthdate of the third other occupant.
Third Other Occupant Social Security Number Text
Enter the Social Security number of the third other occupant.