Tenant Application Form | Moser Properties

Each person over the age of 18 who will be residing in the unit is to fill out a separate application form.

All applications with a copy of your photo ID and income verification are to be dropped off or mailed to the address above.

Property Address

Date

Applicant Information

Last Name

First Name

M.I.

SSN

Date of Birth

Home Phone

Work Phone

Cell Phone

Email

Driver’s License #

State Issued

Vehicle License #

Vehicle Make/Model

Additional Occupants: (List everyone who will live with you)

Full Name

Relationship

Occupation

Age

Full Name

Relationship

Occupation

Age

Full Name

Relationship

Occupation

Age

Rental History

Current Address

City

State

Zip

Landlord/Manager Name

Phone

Dates Occupied

Previous Address

City

State

Zip

Landlord/Manager Name

Phone

Dates Occupied

Previous Address

City

State

Zip

Landlord/Manager Name

Phone

Dates Occupied

Employment History:

Current Occupation:

Employer:

Address:

City:

State

Zipcode:

Supervisor’s Name:

Supervisor’s Phone:

Length of Employment:

Est. Annual Income:

Student Income Information:

1. Are you receiving Financial Aid?

Yes

No

If “Yes”, Enter Amount:

*Per month, year or semester?

2. Are you receiving any Grants?

Yes

No

If “Yes”, Enter Amount:

*Per month, year or semester?

3. Are you receiving money from your parents?

Yes

No

If “Yes”, Enter Amount:

*Per month, year or semester?

Miscellaneous:

Do you have or intend to have liquid furniture?

Yes

No

Do you have ANY pets?

Yes

No

Dog, cat, snake, hamster, fish, etc.?

Do you smoke?

Yes

No

Inside or Outside?

Have you or anyone who will reside with you ever been convicted of a felony?

Yes

No

If “Yes”, what was the conviction and date:

Have you ever:

Filed for Bankruptcy?

Yes

No

Been sued?

Yes

No

Been evicted?

Yes

No

If you answered “Yes”, to any of the above, please explain:

Emergency Contact:

Name:

Relationship:

Address:

Phone:

Alternate Emergency Contact:

Relationship:

Name:

Address:

Phone:

I certify that all the information given above is true and correct and understand that my Rental Agreement may be terminated by Landlord if I have made any misrepresentation in this application. I hereby authorize you to contact any listed references and run a credit report. I understand that this application will be retained regardless of approval.

Full Name:

Date: