Applicant’s Name: and, if applicable, First Co-Applicant’s Name:
and, if applicable, Second Co-Applicant’s Name:
and, if applicable, Third Co-Applicant’s Name:
Application is made to lease property located at for monthly rental of $ Security Deposit: $ Lease Term: Move-in Date: Move-out Date:
Additionally, the Application fee of $40 (“the Application Fee”) is to be used by the Landlord/Agent for the credit/consumer check and processing the application with the understanding that this application, including each prospective occupant is subject to Landlord’s approval and acceptance. Should the actual cost expended for a credit check or other expenses arising out the Application exceed the amount of the Application fee, a portion of the Deposit shall be applied to pay such excess cost. When so approved and accepted, Applicant agrees to execute a lease and to pay any balance due on the security deposit and/or the first month’s rent (as required by Landlord) within three (3) business days after being notified of acceptance and before possession is given.
Military/Diplomatic Clause: YesNo
OCCUPANTS: The premises are to be occupied only by the following # of occupants.
Total Number of Occupants:
AUTOMOBILES, MOTORCYCLES, TRUCKS, BOATS, AND TRAILERS:
Total Number of Vehicles:
Type/Make: Year: Tag #: State:
Are any of the above commercial vehicles? If so, which ones?
All motor vehicles or trailers shall have current licenses and may be parked ONLY in garages, driveways, if provided, on the street (not in fire lanes or on the lawn), OR AS REQUIRED BY THE CONDOMINIUM OR HOMEOWNER’S ASSOCIATION.
In compliance with federal fair housing regulations, the Property shall be made available to all persons without regard to race, color, religion, national origin, sex, physical or mental handicaps, familial status or any additional protected classes specified by State of Maryland or local jurisdiction law.
For Office Use Only:
Date Application Received by Agent/Broker:
Applicant’s Name: Birth Date: SS#:
Driver’s License # or Government-Issued ID #: State:
Home Phone: Temporary Local # (if applicable):
Office Phone: Mobile Phone:
E-mail Address: E-mail Address:
Present Landlord/Agent: Phone:
Reason for moving
Have you ever paid late? NoYes
Have you ever been evicted? NoYes
List all previous addresses for the last two years including period of stay in each and the name and telephone number of Landlord/ Agent from whom you rented. (Use additional sheet if needed).
Landlord/Agent’s Name: Phone:
From To Monthly Rent: $
From To Monthly Rent: $
Position: How long:
Supervisor: Supervisor’s Phone:
CURRENT GROSS ANNUAL INCOME:
Base Pay: $ Overtime: $ Bonuses: $ Commissions: $ Dividends: $ Other: $ TOTAL: $
If employed less than one year with current employer, give previous employment information:
Position: How long? Gross Income: $
IF EMPLOYER REFUSES to verify applicant’s employment by phone, it shall become the responsibility of the applicant to provide immediate written confirmation of such information. If applicant is self-employed, attach copies for past two years of individual US tax form 1040 and self-employment US tax schedule C.
HOUSING ASSISTANCE PROGRAM
Are you participating in a Housing Assistance Program? NoYes
If yes, please complete info:
Jurisdiction: Amount: $
Checking Account: $ Bank:
Savings Account: $ Bank:
Credit Union: $ Bank:
Other Assets: $ Specify:
LIABILITIES (Auto Loans, Mortgages, Credit Cards, Bank Loans, Installment Loans, Student Loans, Child Support, Alimony etc.)
Have you ever filed for bankruptcy? NoYes
Are you obligated to payor receive
If so, indicate monthly payment: $
APPLICANT: Citizen of Passport #:
Emergency Contact: Relationship:
THE FOLLOWING PARAGRAPHS ARE REQUIRED IN MONTGOMERY COUNTY, MARYLAND
ELECTRONIC SIGNATURES: In accordance with the Uniform Electronic Transactions Act (UETA) and the Electronic Signatures in Global and National Commerce Act, or E-Sign (the Act), and other applicable local or state legislation regarding Electronic Signatures and Transactions, the applicant(s) do hereby expressly authorize and agree to the use of electronic signatures as an additional method of signing and/or initialing this application and/or any future contracts or addenda. The applicants hereby agree that either party may sign electronically by utilizing a digital signature service.
AUTHORIZATION TO RELEASE INFORMATION
The undersigned applicant affirms under the penalties of perjury that I have read and understand pages 1 through 6 of this application and that my answers to the questions on this application are true and correct to the best of my personal knowledge, information and belief and that I have not knowingly withheld any fact or circumstance which would, if disclosed, affect my application unfavorably.
Upon demand made by Listing Broker/Landlord, at any time during the applicant’s tenancy or thereafter, Listing Broker/Landlord is hereby authorized to release any information contained in this application to any consumer reporting agency, credit bureau, or other investigative agencies.
The Applicant hereby authorizes Listing Broker/Landlord to order and obtain a credit/consumer report. I hereby authorize the owner or owner’s agent to whom this Application is made and any credit bureau or other investigative agency used by such owner or owner’s agent to investigate and to report and disclose to the owner and the owner’s agent the results of the references herein listed, statements and other data obtained from me or from any other person pertaining to my credit, employment, rent history and financial responsibility. In the event the Listing Broker is acting on behalf of the Landlord, another broker or other party directly or indirectly affected by said transaction, the applicant hereby authorizes the Listing Broker to forward and disclose all or any portion of the information contained in the credit/consumer report to the Landlord, another Broker or other party directly or indirectly involved. The applicant hereby releases Listing Broker/Landlord from any liability whatever for rejection of this application due to credit information or any other reason.” After this application has been processed, the Landlord/Owner may be contacted for final approval. Applicant will be contacted when approval is received or denied.
I understand that this APPLICATION DOES NOT CONSTITUTE A COMMITMENT to lease or rent and that a WRITTEN LEASE WILL BE PREPARED if my application is approved. I further understand that the lease MUST BE SIGNED BY THE LANDLORD AND/OR ITS AGENT AND ME TO BE VALID.
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If you have questions about the contents of this document, you can email the document owner.
Document Name: Rental Applications
Agree & Sign