RESIDENTIAL RENTAL APPLICATION

Rental Property Address
Current Address
Employer Address
Previous Employer Address

REFERENCES (OTHER THAN RELATIVES)

Name
Address
Name
Address

CO-APPLICANTS/ADDITIONAL TENANTS

If a second adult will be renting the premises, they will need to complete a separate rental application form.

Please provide the names of other tenants, including children & co-applicants, who will live on premises (even if on a temporary basis)

Current Address
Current Address

BACKGROUND INFORMATION

Have you ever been convicted of a felony?
Have you ever been evicted from any rental premises?
Are there any circumstances which may interrupt your income or ability to pay rent?

PLEASE READ THE FOLLOWING AND SIGN AND DATE

The applicant understands and agrees that if this application is accepted and the applicant fails to execute a lease before the beginning date specified above, or to pay the required deposits along with the first month’s rent, the application and deposit will be forfeited as liquidated damages. 

It is also understood that if the application is not accepted, or if the premises are not ready for occupancy by the applicant on the beginning date specified above, the deposit shall be returned to the applicant, upon the applicant’s request. 

The applicant understands that River Valley Holdings, LLC reserves the right to perform a credit check to verify the applicant’s credit references and history in connection with the processing of this rental application. A credit report fee of $25 is due upon submission of this application. 
 

The applicant understands that a security deposit and first month’s rent is due at the time the lease is signed. Amount will vary depending on the property. Security deposit is equal to first month’s rent. 

It is against the law to discriminate against prospective tenants on the basis of race, religion, national origin, age, disability or family status. Local or state laws may include additional classes which are protected from discrimination in housing. 

The information provided by the prospective tenant(s) may be used by River Valley Holdings, LLC to determine whether to accept this application. Upon written request within 60 days, River Valley Holdings, LLC will disclose to the applicant in writing the nature and scope of any investigation River Valley Holdings, LLC has requested, and will, if the application is refused, state in writing the reason for refusal. 
I authorize that River Valley Holdings, LLC can investigate my credit, tenant, banking and employment history for the purposes of renting a house, apartment, or condominium from this owner, manager, brokerage, finder, agent or leasing company.