APPLICATION FOR RENTAL
Notice: All adult applicants (18 years or older) must complete a separate application for rental.
APARTMENT

RENT

START DATE

AGENT/REFERRED BY

M.I.

SSN

WORK PHONE
)

EMAIL

CITY

STATE

APPLICANT INFORMATION
LAST NAME

FIRST NAME

BIRTH DATE
(

HOME PHONE
)

(

DRIVER'S LICENSE #

CURRENT ADDRESS
STREET ADDRESS
DATE IN

DATE OUT

ZIP

LANDLORD NAME
(

MONTHLY RENT
$

LANDLORD PHONE
)

REASON FOR LEAVING

PREVIOUS ADDRESS
STREET ADDRESS
DATE IN

CITY
DATE OUT

STATE

ZIP

LANDLORD NAME
(

MONTHLY RENT
$

LANDLORD PHONE
)

REASON FOR LEAVING

OTHER OCCUPANTS
LIST NAMES AND BIRTH DATES OF ALL ADDITIONAL OCCUPANTS 18 YEARS OR OLDER

LIST NAMES AND BIRTH DATES OF ALL OCCUPANTS 18 YEARS OR YOUNGER

PETS
PETS?

DESCRIBE

EMPLOYMENT & INCOME INFORMATION
1. OCCUPATION

EMPLOYER/COMPANY

SUPERVISOR NAME
(
2. OCCUPATION
SUPERVISOR NAME
(

SUPERVISOR PHONE
)
EMPLOYER/COMPANY

START DATE

MONTHLY SALARY
$
END DATE

SUPERVISOR PHONE
)

START DATE

MONTHLY SALARY
$
END DATE

1. OTHER INCOME DESCRIPTION

MONTHLY INCOME
$
MONTHLY INCOME
$

2. OTHER INCOME DESCRIPTION

EMERGENCY CONTACT
1. NAME

ADDRESS

PHONE
)
PHONE
(
)

RELATIONSHIP

PHONE
)
PHONE
(
)

RELATIONSHIP

(
2. NAME

ADDRESS

RELATIONSHIP

PERSONAL REFERENCES
1. NAME

ADDRESS

(
2. NAME

ADDRESS

RELATIONSHIP

BACKGROUND INFORMATION
HAVE YOU EVER:

Filed for bankruptcy?

Willfully or intentionally refused to pay rent when due?

Been evicted from a tenancy or left owing money? If yes, please provide Property Name, City, State, and Landlord Name.
Yes No
Been convicted of a crime? If yes, please provide Type of Offense, County, and State.
Yes No

VEHICLE INFORMATION
1. MAKE & MODEL

YEAR

LICENSE NO. & STATE

2. MAKE & MODEL

YEAR

LICENSE NO. & STATE

OTHER VEHICLES

OTHER INFORMATION
HOW DID YOU HEAR ABOUT THIS PROPERTY?
PLEASE INCLUDE ANY OTHER INFORMATION YOU BELIEVE WOULD HELP TO EVALUATE THIS APPLICATION

I/we, the undersigned, authorize On-Site.com, Landlord and its agents to obtain an investigative consumer credit report including but not limited to credit history, OFAC search, landlord/tenant court record search, criminal record search and registered sex offender search. I authorize the release of information from previous or current landlords, employers, and bank representatives. This investigation is for resident screening purposes only, and is strictly confidential. This report contains information compiled from sources believed to be reliable, but the accuracy of which cannot be guaranteed. I hereby hold
On-Site.com, Landlord and its agents free and harmless of any liability for any damages arising out of any improper use of this information.
Important information about your rights under the Fair Credit reporting Act:
• You have a right to request disclosure of the nature and scope of the investigation.
• You must be told if information in your file has been used against you.
• You have a right to know what is in your file, and this disclosure may be free.
• You have the right to ask for a credit score (there may be a fee for this service).
• You have the right to dispute incomplete or inaccurate information. Consumer reporting agencies must correct inaccurate, incomplete, or unverifiable information.
These reports are being processed by On-Site.com, P.O. Box 1514, Los Altos, CA 94023-1514, (877) 222-0384.
A summary of your rights under the Fair Credit Reporting Act is available by visiting or writing (Para information en espanol, visite o escribe): http://www.ftc.gov/credit
Consumer Response Center, Room 130-A, Federal Trade Commission, 600 Pennsylvania Avenue N.W., Washington D.C.
20580

***SIGN HERE*** { } {} {} {}

(Signed/Applicant)

Date

Consumer Report Disclosure and Authorization
In connection with my application for housing, I understand that the property owner/agent may obtain one or more consumer reports, which may contain public information, for the purposes of evaluating my application. These consumer reports will be obtained from one or more of the following consumer reporting agencies: •
•
•
•
•

Equifax, E.C.I.F., P.O. Box 740241, Atlanta, GA, 30374-0241, (800) 685-1111
Trans Union, Regional Disclosure Center, 1561 Orangethorpe Ave., Fullerton, CA, 92631, (714) 738-3800
Experian (TRW), Consumer Assistance, P.O. Box 949, Allen, TX, 75002, (888) 397-3742
On-Site Manager, Inc., P.O. Box 1514, Los Altos, CA, 94023-1514, (877) 222-0384

Under California law, these consumer reports are defined as investigative consumer reports. These reports may contain information on my character, general reputation, personal characteristics and mode of living. In connection with my application for housing, I authorize owner/agent to obtain a consumer report from the consumer reporting agencies listed above.

Signature:

________________________________________

Name Printed:

________________________________________

Date:

________________________________________

If you would like to receive a copy of any investigative consumer report at no cost to you, please initial here: ______
If you would like to receive a copy of any credit report at no cost to you, please initial here: ______
PLEASE NOTE:
Under Section 1786.22 of the California Civil Code, if you wish to dispute the accuracy or completeness of any item in the consumer report, you may contact the consumer reporting agency named above and request an investigation. You also may view the file maintained on you by the above credit reporting agency during normal business hours. You can receive a copy of your file by providing proper identification and paying any related-copy costs. You may also receive a summary of the file by telephone. The agency is required to have employees available to explain your file to you, and they must explain any coded information in your file.
You can bring someone with you to view the file, so long as they have identification.