Standard Financially Responsible Rental Application

Property

Apartment Complex *

Unit Number

Date Unit Wanted

Application Type

New Move-In Occupant Turning 18 Add/Remove Roommate Transfer

Applicant Information

Applicant Full Legal Name *

Email *

Previous Names, Aliases or Nicknames Used

Date of Birth * (MM/DD/YYYY)

Social Security # *

Applicant Phone *

Photo I.D. Type *

ID Number *

State

Exp. Date (MM/DD/YYYY)

Current Residence

Current Street Address *

Date You Moved In * (MM/DD/YYYY)

City *

State *

ZIP *

Current Landlord Name *

Landlord Phone *

Landlord Email

Landlord Fax

Landlord Street Address (or Apartment Name)

City

Why are you moving? *

Former Residence (Required if at current address less than 2 years)

Former Street Address

City

State

ZIP

From (MM/DD/YYYY)

To (MM/DD/YYYY)

Former Landlord Name

Landlord Phone

Landlord Email

Landlord Fax

Landlord Street Address (or Apartment Name)

City

State

ZIP

Why did you move?

Other States and Counties You Have Lived in During the Past 5 Years

Current Employment

Current Employer *

Phone *

HR Email

HR Fax

Street Address

City

State

ZIP

Position *

How Long?

Gross Monthly Income $ *

Are You Self-Employed? *

Yes No

Other Monthly Income — Source

Amount $

Source 2

Amount $

Previous / Additional Employment

Type

Previous Additional

Employer Name

Phone

HR Email

HR Fax

Street Address

City

State

ZIP

Position

How Long?

Gross Monthly Income $

Other Occupants

Name

Date of Birth (MM/DD/YYYY)

Vehicles

Make

Model

Color

State

License Plate #

Owner

Pets

Pets are allowed subject to approval by management.

How many pets will be residing in this unit?

Name

Type

Breed

Age

Weight

Do you intend to use:

Waterbed Aquarium Musical Instrument

Other Information

Do you have Renter's Insurance? *

Yes No

Emergency Contact *

Phone *

Emergency Contact Address

Contact in Case of Death

Phone

Address

Have you been evicted within the last 5 years or is there a pending eviction case against you? *

Yes No

If yes, please list County & State

Have you ever filed for bankruptcy, or are you currently in the bankruptcy process? *

Yes No

If yes, date (MM/DD/YYYY)

Have you ever had a home foreclosed on, or are you currently in the foreclosure process? *

Yes No

If yes, date (MM/DD/YYYY)

Have you or any other person who will be occupying the unit ever been convicted of, or pled guilty or no contest to, any felony or misdemeanor related to the criminal conviction criteria? *

Yes No

If yes, who

County & State

When (MM/DD/YYYY)

What

Have you or any other person who will be occupying the unit been arrested for a charge related to the criminal conviction criteria that has not been dismissed? *

Yes No

If yes, County & State

Why are you vacating your present place of residence? *

Have you given legal notice where you now live? *

Yes No

How did you hear about our property?

Additional Comments

Personal References

Next of Kin * (Name, Address, Relationship, Phone)

Reference 1 * (Name, Address, Relationship, Phone)

Reference 2 * (Name, Address, Relationship, Phone)

Applicant Screening Fee Disclosure

Owner/Agent has charged a screening charge as set forth above. Owner/Agent may obtain a consumer credit report and/or an Investigative Consumer Report which may include the checking of the applicant's credit, income, employment, rental history, and criminal court records and may include information as to his/her character, general reputation, personal characteristics, and mode of living. You have the right to request additional disclosures provided under Section 606(b) of the Fair Credit Reporting Act, and a written summary of your rights pursuant to Section 609(c).

Screening Company: Equifax | Phone: 1-888-378-4329 | Address: P.O. Box 740256, Atlanta GA 30374

If the application is approved, applicant will have 48 hours from the time of notification to execute a rental agreement and make all deposits required thereunder or make a deposit to hold the unit.

View Disclosure Documents Download Disclosure Documents

I certify that the above information is correct and complete and I have read, understand, and agree to the Disclosure Documents, Applicant Screening Process, and Applicant Screening Policies.

CITY OF PORTLAND AND SALEM, OREGONSTANDARD FINANCIALLY RESPONSIBLE RENTAL APPLICATION

Property

Applicant Information

Current Residence

Former Residence (Required if at current address less than 2 years)

Current Employment

Previous / Additional Employment

Other Occupants

Vehicles

Pets

Other Information

Personal References

Applicant Screening Fee Disclosure

CITY OF PORTLAND AND SALEM, OREGON
STANDARD FINANCIALLY RESPONSIBLE RENTAL APPLICATION