Rental Application Form – Fill in the Blanks

Instructions: Complete the rental application form with your own (real or imaginary) information. Practice using formal English and common rental vocabulary.

1. Personal Information

Full Legal Name:

Date of Birth (MM/DD/YYYY):

Phone Number:

Email Address:

Current Address:

How long at this address?

Reason for moving:

2. Employment & Income

Current Employer:

Employer Address:

Position/Job Title:

Length of Employment:

Monthly Income (before tax):

Supervisor's Name & Contact:

3. Rental History

Current Landlord's Name:

Landlord's Phone Number:

Monthly Rent Amount:

Dates of Residence:

Ever evicted or asked to leave?

Yes No

If yes, please explain:

4. Household Information

Total number of occupants:

List names and ages of all other occupants:

Do you have pets?

Yes No

If yes, type, breed, weight:

Do you or any occupants smoke?

Yes No

5. Reference

Reference Name (not family):

Relationship:

Phone Number:

6. Emergency Contact

Full Name:

Relationship:

Phone Number:

7. Consent and Declaration

I certify that all information provided is accurate and complete. I authorize the landlord or property manager to contact employers, landlords, and references listed above, and to run a background or credit check if necessary.

Signature:

Date:

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