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Rental application

Every field is required. Empty fields are marked in red. Social security and driver's license numbers are masked while you type and encrypted before they are stored.

The home

Home you are applying for

About you

Full legal name

Date of birth

Social security number

Encrypted on this site with AES-GCM before it is stored. After you submit, only the last four characters are shown unless the owner reveals the full value.

Driver's license number

Encrypted on this site with AES-GCM before it is stored. After you submit, only the last four characters are shown unless the owner reveals the full value.

License state

Phone

Where you live now

Street address

City

State

Postal code

How long at this address

Current monthly rent

Current landlord

Landlord phone

Reason for moving

Work and income

Employer

Position

Employer phone

Gross monthly income

Length of employment

Other income (write None if there is none)

Household

Other people who will live in the home (names, relationships, and ages, or None)

Emergency contact

Emergency phone

Relationship

Vehicle (year, make, model, plate, or None)

Pets (type and weight, or None)

History

Have you ever been evicted?

Yes No

Explain, or write None

Have you filed for bankruptcy?

Yes No

Explain, or write None

Have you been convicted of a felony?

Yes No

Explain, or write None

Desired move-in date

Documents

Photo ID

Proof of income

Authorization and signature

I authorize Bretz and Foltz Properties LLC to verify the information in this application, including my identity, employment, income, and rental history, and, where used, credit and background reports. I certify that every statement is true and complete. I understand that false or incomplete information can be grounds for denial or for ending a later tenancy.

Type your full legal name as your signature

Date

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The home

Home you are applying for

About you

Full legal name

Date of birth

Social security number

Encrypted on this site with AES-GCM before it is stored. After you submit, only the last four characters are shown unless the owner reveals the full value.

Driver's license number

Encrypted on this site with AES-GCM before it is stored. After you submit, only the last four characters are shown unless the owner reveals the full value.

License state

Phone

Where you live now

Street address

City

State

Postal code

How long at this address

Current monthly rent

Current landlord

Landlord phone

Reason for moving

Work and income

Employer

Position

Employer phone

Gross monthly income

Length of employment

Other income (write None if there is none)

Household

Other people who will live in the home (names, relationships, and ages, or None)

Emergency contact

Emergency phone

Relationship

Vehicle (year, make, model, plate, or None)

Pets (type and weight, or None)

History

Have you ever been evicted?

Yes No

Explain, or write None

Have you filed for bankruptcy?

Yes No

Explain, or write None

Have you been convicted of a felony?

Yes No

Explain, or write None

Desired move-in date

Documents

Photo ID

Proof of income

Authorization and signature

Type your full legal name as your signature

Date