Single Room Occupancy Lease Application
Applicant Information
Full Legal Name
Date of Birth
Phone Number
Email Address
Current Residential Address
Social Security Number
Govt. ID Number
Rental History
Previous Address
Previous Landlord Name
Landlord Contact
Duration of Stay
Reason for Leaving
Employment & Income
Current Employer
Employer Contact
Occupation
Monthly Income
Other Income (describe)
References
Reference Name
Contact Information
Reference Name
Contact Information
Additional Information
Do you have pets?
No
Yes
Do you smoke?
No
Yes
Any prior evictions/criminal history?
Other Information
Certification & Signature
I certify that the above information is true and complete.
Date