Rent Oregon

Rent Application Form

For Property At:

Deposit:

Lease Term From:

Lease Term To:

Applicant

SS#

D.O.B:

Co-Applicant:

SS#

D.O.B:

Other Person(s) sharing rental? (name & age):

Will they reside here?

Full Time?

Part Time? (Explain)

Home Phone:

Work Phone:

Email Address:

Mailing address (if different from residence):

Reason for vacating present home:

Does Owner know?

If no, Why?

Present Address:

Date From:

Date To:

Apt./Mortgage Co. Name:

Landlord Phone #

Monthly Payment $

Reason for moving:

Previous Address:

Date From:

Date To:

Apt./Mortgage Co. Name:

Landlord Phone #

Monthly Payment $

Reason for moving:

Present Employer:

Phone #

Business Address:

Phone #

Supervisor:

Employed Since:

Gross monthly salary:

Previous Employer:

Phone #

Business Address:

Phone #

Supervisor:

Employed Since:

Gross monthly salary:

Co-Occupant's Employer:

Phone #

Supervisor:

Employed Since:

Gross monthly salary:

Additional mo. income. if any:

Source

Checking Account No #

Bank Name & City:

Saving Account No #

Bank Name & City:

Firm & City:

Acct#

Mo. Payment $

Firm & City:

Acct#

Mo. Payment $

Firm & City:

Acct#

Mo. Payment $

Year & Make:

Color:

Lic plate & stete:

Year & Make:

Color:

Lic plate & stete:

Have you/co-occupant ever been convicted of a felony?

Do you have any points?

Do you or any household member receive Section 8 rental assistance?

If yes- BHA, VSHA, or WHA (circle one) :

Emergency Contact (nearest relative not living with you):

Relationship:

Home Phone #

Work Phone #

In the event of serious illness or death or resident, the above emergency contact IS IS NOT authorized to enter the apartment and move all contents. (select one)

I warrant that the information supplied is true and correct, and that I am at least 18 years of age. I have been informed that the Owner/Company may check my credit to evaluate my qualifications as a potential tenant. Owner/Company is allowed to contact any credit reporting companies to report any rent delinquency or eviction proceedings to Owner/Company. Owner/Company warrants that any verifications are for the purpose of entering into a Rental agreement, and further warrants that any information derived from credit reports or other sources will be kept confidential and not revealed to any outside party. Applicant(s) acknowledge that false information herein may constitute grounds for rejection of this application, termination or occupancy; any may constitute criminal offense under the laws of this state.

I accept

Rent Oregon

Rent Application Form

You can also get this form here and submit at our office.

Click here to download application