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Louisiana Rental Application Form


Louisiana Rental Application Form
Louisiana Rental Application Form
LOUISIANA RENTAL APPLICATION
Equal Housing Opportunity. Please Complete All Information
Bel
ow.
Applicants
Full
Name
Phone
#
DOB
Social
Security
#
Drivers
License
#
State
Exp.
Current
Address
City
State
Zip
Current
Landlords
Name
Phone
#
How
long
at
this
address
Reason
for
leaving
Previous
Address
City
State
Zip
Previous
Landlords
Name
Phone
#
How
long
at
this
address
Reason
for
leaving
Auto
Yr
Make
Model
State/License
Plate
#
Employer
Position
Income
Employers
Address
City
State
Phone
#
How
long
at
job
Other
income/source
Do you allow smoking in the home [ ] Yes [ ] No Have you ever been evicted [ ] Yes [ ]
No
Have you ever been convicted [ ] Yes [ ] No If Yes to any of these, you may explain on the reverse of
application.
Preferred
move-in
date
Number
and
type
of
Pets
Name
of
bank
Branch
Type
of
Account
Name
of
bank
Branch
Type
of
Account
Personal
References
Name
Yrs.
Known
Relationship
Phone
#
Name
Yrs.
Known
Relationship
Phone
#
Name
Yrs.
Known
Relationship
Phone
#
Total
number
of
adults
,
total
number
of
children
living
with
you
under
the
age
of
18
Names and relations of all other applicants ,
,
,
,
I CERTIFY that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all
s
tateme
n
t
s
contained in this application for tenant screening as may be necessary in arriving at a tenant decision, I understand that the
la
nd
l
ord
may terminate any rental agreement entered into for any misrepresentations made
a
bov
e
.
Applicant
Signature
Date
Landlord or Representative received from applicant a deposit of
$
dollars, of which $ will be non-refundable and
us
e
d
for application and tenant screening services. The balance will be applied to the remaining deposit due, or refunded if the applicant
i
s
no
t
a
pprov
e
d.
In
iti
a
l
Louisiana Rental Application Form