Rental Application Form — WestCoastRealty

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1234 Pacific Coast Hwy, Suite 200 · Santa Monica, CA 90401

(310) 555-0100 · [email protected]

RENTAL APPLICATION

Date: ___________________________

Property Address: ________________

Important: All adults 18 years of age or older who will reside in the unit must complete a separate application. Incomplete applications will not be processed. WestCoastRealty is an Equal Housing Opportunity provider.

1. Applicant Information

First Name

Last Name

Middle Name

Date of Birth (MM/DD/YYYY)

Social Security Number (last 4 digits)

Government-Issued ID Type

ID Number

ID Expiration Date

Home Phone

Cell Phone

Email Address

2. Current Residence

Current Street Address

City

State

ZIP Code

Monthly Rent

How long at this address?

Current Landlord / Property Manager Name

Landlord Phone Number

Reason for Leaving

3. Previous Residence (if less than 2 years at current address)

Previous Street Address

City

State

ZIP Code

Monthly Rent

Dates of Residency (From – To)

Previous Landlord Name

Landlord Phone Number

Reason for Leaving

4. Employment & Income

Current Employer Name

Employer Phone Number

Job Title / Position

Length of Employment

Gross Monthly Income

Supervisor / HR Contact Name

Additional Income Sources (freelance, rental income, benefits, etc.)

Additional Monthly Income Amount

5. Credit Report

Save Time & Money: If you have a valid credit report dated within the last 45 days, you may submit it with this application instead of authorizing a new credit pull. Please attach a copy to this form.

I authorize WestCoastRealty to obtain a credit report on my behalf.I am attaching a credit report dated within the last 45 days.

Credit Report Date (if attaching)

6. Additional Occupants

List all persons who will reside in the unit (other than the applicant). All adults 18+ must submit a separate application.

Full Name	Relationship	Date of Birth	Adult (18+)?

7. Pets & Vehicles

Do you have pets?

No Yes (complete below)

Do you smoke?

No Yes

Pet Type & Breed

Weight (lbs)

Number of Vehicles

Vehicle 1: Make / Model / Year / License Plate

Vehicle 2: Make / Model / Year / License Plate

8. Emergency Contact

Full Name

Relationship

Phone Number

9. Personal References (non-family)

Reference 1 Name

Relationship

Phone Number

Reference 2 Name

Relationship

Phone Number

10. Background Disclosure

Have you ever been evicted or asked to vacate a rental property?

Yes No

Have you ever broken a lease agreement?

Yes No

Have you ever filed for bankruptcy in the last 7 years?

Yes No

Have you ever been convicted of a felony?

Yes No

If yes to any of the above, please explain

11. Authorization & Signature

I/We hereby authorize WestCoastRealty and its agents to verify the information provided in this application, including but not limited to: credit history, rental history, employment history, and personal references. I/We certify that all information provided is true and accurate to the best of my/our knowledge. I/We understand that any misrepresentation or omission of facts may result in rejection of this application or termination of tenancy. I/We acknowledge that submission of this application does not guarantee tenancy. WestCoastRealty complies with all applicable Fair Housing laws and does not discriminate on the basis of race, color, religion, sex, national origin, disability, familial status, or any other protected class.

Applicant Signature

Signature

Date

MM / DD / YYYY

Printed Name

Co-Applicant Signature (if applicable)

WestCoastRealty · 1234 Pacific Coast Hwy, Suite 200, Santa Monica, CA 90401(310) 555-0100 · [email protected]Equal Housing Opportunity

WestCoastRealty Rental Application Form