RESIDENTIAL RENTAL APPLICATION                                               Back to main page

Address, Floor and/or Unit                                                    Troy NY 12180

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Name                                                    Phone______________ Email                                                

Present Address                                                                                                                                   

How Long There?                                              S.S. Number________-____-_______

Which state and country are you a citizen / resident of                                                                            

Present Landlord                                                                                    Phone                                     

Address                                                                                                                                               

Annual Rent                              Reason for Leaving                                                                              

Full names of all individuals who will be occupying premises                                                                    

                                                                                                                                                             

Have you ever been evicted, sued for nonpayment of rent, or breached a lease ? (if so, explain)                

Present Employer                                                          Phone                                                             

Address                                                                          Occupation / Program                                     

Gross Mo.Sal.                           Length of Emp./ School             Expected Departure Date                     

Parent / Guardian contact info; Names                                                                      

Phone                                                   Address (s)                                                      

                                                                                                                            

 

I certify that the information on the residential rental application is true and complete.  I authorize the verification

of this information by contacting any or all individuals and financial institutions listed above.  I understand that this

is not a lease or an offer to rent.  No binding obligation of any kind exists between the owner and myself unless

and until a lease is signed. This application is subject to prior applications.  This Application shall remain the

property of the owner.

Signature of Applicant________________________________Date__________

NO PERSON SHALL BE DENIED THE RIGHT TO RENT OUR PROPERTY
BECAUSE OF THEIR RACE, COLOR, RELIGION, SEX, NATIONAL ORIGIN
OR ANCESTRY.                                                                   
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