Application Form

Address Applying For
RJR Maintenance and Management will be requesting the following items: a credit report, a criminal background check, a renter’s background check, employment verification, a copy of state issued ID and Social security card. The cost for this service will be $30 per applicant.

As part of the application process, I authorize RJR Maintenance and Management to request reports and check as identified and understand that the above fees are non-refundable and do not obligate RJR Maintenance and Management to deliver possession or keys to the premises. I understand the criteria necessary to rent from RJR Maintenance and Management and have been provided with a copy of the terms. (Attached to PDF) No contract will be established between the parties until a lease agreement has been signed by all parties.
Name*
First Last
Date*
MM
DD
YYYY

Name*
First Middle Last
Birthdate*
MM
DD
YYYY
Phone*
Email*
Present Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Social Security Number*
Driver's License Number*
Present Employer*
Phone*
Position/Title*
Present Monthly Income (net)*
Wage*
Hours Worked a Week*
Name of occupants that will be occupying the unit*

One is required, if this is your first time renting please put N/A in all fields.
Name of present Landlord or Property Management Company*
Phone*
Address Lived At*
Date Moved In*
Date Moved Out*
Rent Per Month*
Reason For Leaving*
Name of past Landlord or Property Management Company
Phone
Address Lived At
Date Moved In
Date Moved Out
Rent Per Month
Reason For Leaving
Name of past Landlord or Property Management Company
Phone
Address Lived At
Date Moved In
Date Moved Out
Rent Per Month
Reason For Leaving

Name of nearest relative not living with you*
Relationship*
Phone*
Address*
Automobile Make and Model*
License Plate Number*
State*

Acknowledgement and Agreement

For purposes of renting, the undersigned acknowledges that they were informed of the rental criteria which was established per the addendum provided.

The undersigned represents that all of the above statements are true and complete and hereby authorize RJR Maintenance and Management, it’s employees, and agents to contact and obtain information from any individuals entities contracted by RJR Maintenance and Management harmless from all causes of action, expenses, losses, damages of any kind arising from or related to information obtained regarding credit history, employment or prior residential agreements of the undersigned.

All persons will be treated fairly and equally without regard to race, color, religion, sex, familial status, handicap, marital status, status with respect to public assistance or national origin in compliance with the Fair Housing Act.
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- By checking this box applicant(s) hereby consent to allow the owner, manager, or his/her/their agent (hereinafter "Landlord") to obtain credit information, criminal history and related information regarding the applicant(s) for the purpose of determining whether or not to enter into a lease with the applicant(s). Applicant(s) understand that Landlord shall have a continuing right to review applicant's credit information, rental application, payment history, occupancy history, criminal background history and related information for account review purposes and for improving application methods.
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- By checking this box applicant(s) hereby declares that all information provided on this Rental Application is complete, true, and correct to the best of his/her/their knowledge. Applicant(s) hereby authorizes the owner, manager, or his/her/their agent (hereinafter "Landlord") to verify any information at any time contained in this application, including but not limited to, verification of current residency and employment. This application is for preliminary screening use only and does not obligate Landlord to execute a rental agreement or deliver possession of the premises. Applicant(s) further acknowledges that any false or fraudulent information contained herein will void this application and terminate any rental agreement.
Name*
First Last
Date*
MM
DD
YYYY

Application

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