Indiana Rental Application

Free Indiana Rental Agreement

Indiana Rental Application

Landlord _________________________________________ Date ______________________

Location of Residence _________________________________________________________

TENANT INFORMATION:

Full Name ___________________________________________________________________

Home Phone ( ) ________ Work Phone ( ) __________ Cell Phone ( ) __________

Date of Birth _____________ Social Security No. ___________________________________

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Drivers License No. ___________________________________________ State ___________

Co-Applicant Name ____________________________________________________________

Co-Applicant Date of Birth ___________ Co-Applicant Social Security No. _______________

Names and Ages of everyone who will live in the residence
_____________________________________________________________________________

List all pets ___________________________________________________________________

Email Address ________________________________________________________________

Vehicle Make/Model ____________________ Year _____ License/State _________________

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EMPLOYMENT INFORMATION:

Applicants Employment Status ___ Full Time ____ Part Time ____ Student ____ Unemployed

Employer______________________________________________________________________

Address ______________________________________________________________________

Job Title ___________________________ Dates employed ____________________________

Supervisor Name _________________________ Phone ( ) ___________________________

Monthly Pay __________________

If you would like us to consider other sources of income for this Rental Application, please list the amount and the person we may contact for confirmation. Please do not reveal alimony, child support, or anyone else’s income unless you want us to consider it in this Indiana Rental Application.

Amount $_____________________________________________________________________

Contact Name _________________________________________________________________

RESIDENTIAL HISTORY FOR LAST 3 YEARS:

Current Address _______________________________________________________________

Move In Date ________________________ Rent $____________________________________

Owner/Agent _________________________________________Phone ( ) _____________

Reason for Leaving _____________________________________________________________

Previous Address ______________________________________________________________

Move In Date ______________ Move Out Date ______________ Rent $__________________

Owner/Agent _________________________________________Phone ( ) _____________

Reason for Leaving _____________________________________________________________

Previous Address ______________________________________________________________

Move In Date ______________ Move Out Date ______________ Rent $__________________

Owner/Agent _________________________________________Phone ( ) _____________

Reason for Leaving _____________________________________________________________

CREDIT HISTORY:

Have you every filed bankruptcy? Yes ___________ No ___________

Have you ever been evicted from a rental residence? Yes ___________ No ___________

Are you a party to any lawsuits? Yes ___________ No ___________

Have you had any late rental payments in the last year? Yes ___________ No ___________

Are there any judgments against you? Yes ___________ No ___________

If you answered yes to any of the above questions, please explain
_____________________________________________________________________________

REFERENCES:

Bank References

Bank Name ___________________________________________________________________

Account Type _________________ Account No. _____________________________________

Bank Name ___________________________________________________________________

Account Type _________________ Account No. _____________________________________

Credit References

Name ____________________________________________ Phone ( ) __________________

By my signature below, I represent that all of the information that I have disclosed in this Indiana Rental Application is true, accurate, and complete. I acknowledge that all of the information I have disclosed is material and Landlord is relying on the information to decide whether to grant or deny this Application.

NAME _________________________________________ DATE ________________________

AUTHORIZATION

I authorize Landlord to order and review my credit and criminal history and investigate the accuracy of all information contained in this Indiana Rental Application. I further authorize all banks, employers, and creditors to provide Landlord any and all information concerning my credit.

NAME _________________________________ DATE _______________________

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