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Iowa Lease Application

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Iowa Lease Application Page 2
Iowa Lease Application
PROCESSING FEE: Applicant has paid the sum of $ ________ as a non -refundable fee for owner s cost of processing application.
CORRECT INFORMATION: Applicant represents that all of the above statements are true and complete, and hereby authorizes verification of
above information, references, and credit records. Applicant acknowledges that false information herein will constitute grounds for rejection of this
application and may be a criminal offense. Applicant agrees to the terms of the “Application Deposit Agreement” below.
APPLICATION DEPOSIT AGREEMENT
Applicant has deposited an “Application Deposit” (in the amount stated below) in consideration of the owner/agent s evaluation of this application.
Applicant agrees to enter into a rental agreement within forty-eight (48) hours of verbal or written notification of application approval. Should
applicant give notice of cancellation before move-in date, or fail to take possession, owner/agent will have the immediate right to take possession and
re-let said dwelling unit. Charges for advertising, verification of information, application approval, any and all other out-of-pocket rental expenses,
and daily rent loss until dwelling unit is re-let will be deducted from security deposit. If said charges exceed security deposit amount, applicant shall
be liable for the deficiency. Owner/agent shall use due diligence in mitigating applicant s damages. Applicant agrees that only in the event this
application is rejected by owner/agent, shall applicant be entitled to a refund of security deposit less a twenty-five dollar ($25.00) fee for the owner s
cost of processing the application.
DATED THIS _____________________ DAY OF ___________________________, __________, AT POLK COUNTY, IOWA.
APPLICANT S SIGNATURE _________________________________ SPOUSE S SIGNATURE _____________________________________
PHONE NUMBER __________________________________________ PHONE NUMBER __________________________________________
HOW WERE YOU REFERRED TO THIS COMMUNITY (Please circle one): NEWSPAPER AD REFERRAL
FORMER RESIDENT (Name) ______________________________ CURRENT RESIDENT (Name) _________________________________
DROVE BY AND CAME IN _______________________________ OTHER ____________________________________________________
APPLICANTS - DO NOT WRITE BELOW THIS LINE:
==============================================================================
LANDLORD: Rated _____________By _____________ Date _____________ Rated ____________By __________ Date ___________
Accepted ____________________
CREDIT: Rated _____________By_____________ Date _____________ Rated ____________By __________ Date ___________
Rated _____________By _____________Date _____________ Rated ____________By__________ Date ___________
CREDIT
BUREAU Rated _____________By _____________Date______________ Rated ____________By__________ Date ___________
EMPLOYMENT: Outlook for work Applicant ____________________ Spouse _______________________
CLAUSES: Co-Signer _______________ Pet Addendum ___________________ Other __________________________
APPLICATION DEPOSIT: $ ____________________ RECEIPT NO. _________________ DATE PAID_________________
RENT PER MONTH _____________________
BALANCE OF DAMAGE DEPOSIT: $ _______________________ LEASE TERM __________________________________________
PET DEPOSIT: $ _______________________ TYPE OF APARTMENT _________________________________
PRO-RATED AMOUNT OF RENT: $ _______________________ MOVE-IN DATE ________________________________________
FULL ____________ MONTH RENT: $ _______________________
TOTAL OWED PRIOR TO OCCUPANCY: $ _______________________ RECEIPT NO. ________________ DATE PAID ______________
Iowa Lease Application