Rental Application

Your application must include and cannot be processed without the following:

  1. Rental application form (either submit below, or download (right click) it as a .doc file and mail or fax it).
  2. Successful credit check.
  3. Application fee of $60 for single person or $100 for two people (either by Paypal or check), half of which will be returned if and when you sign the lease.
  4. Security deposit of one month's rent (either by Paypal or check).
  5. A copy of your driver's license and social security card (either by mail, email or fax).

Please send the above information to either:


If you have any questions, you can call us at (443) 858-6003.


Part 1 of 15: Property
Date of Anticipated Move-In * Required
Property Address * Required
Monthly Rent * Required
Security Deposit * Required
Pet Deposit * Required

Part 2 of 15: Applicant
Applicant's Full Name * Required
Present Street Address * Required
Present Street Address, Line 2 * Required
Present City * Required
Present State * Required
Home Phone Number * Required
Work Phone Number * Required
Date of Birth * Required
Social Security Number * Required
Driver's License Number * Required
Email Address * Required

Part 3 of 15: Employment
Name of Present Employer * Required
Address of Present Employer * Required
Present Position * Required
Length of Time of Present Position * Required
Present Monthly Salary * Required
Supervisor's Name * Required
Supervisor's Phone Number * Required
Previous Employer * Required
Address of Previous Employer * Required
Previous Position * Required
Length of Time of Previous Position * Required
Previous Monthly Salary * Required
Previous Supervisor's Name * Required
Previous Supervisor's Phone Number * Required
Other Source of Income, 1.
Other Source of Income, 2.

Part 4 of 15: Spouse
Spouse's Full Name
Spouse's Phone Number
Spouse's Work Phone Number
Spouse's Date of Birth
Spouse's Social Security Number
Spouse's Driver's License Number
Spouse's Email Address

Part 5 of 15: Spouse's Employment
Name of Spouse's Present Employer
Address of Spouse's Present Employer
Spouse's Present Position
Length of Time of Spouse's Present Position
Spouse's Present Monthly Salary
Spouse's Supervisor's Name
Spouse's Supervisor's Phone Number
Spouse's Previous Employer
Address of Spouse's Previous Employer
Spouse's Previous Position
Length of Time of Spouse's Previous Position
Spouse's Previous Monthly Salary
Spouse's Previous Supervisor's Name
Spouse's Previous Supervisor's Phone Number
Spouse's Other Source of Income, 1.
Spouse's Other Source of Income, 2.

Part 6 of 15: Present Landlord or Mortgage Company
Present Landlord or Mortgage Company * Required
Landlord's Phone Number * Required
Monthly Rent or Mortgage Payment * Required
Date of Move-In * Required
Date of Move-Out * Required

Part 7 of 15: Previous Landlord
Previous Landlord or Mortgage Company
Previous Landlord's Phone Number

Part 8 of 15: Personal References
Reference Name, 1. * Required
Reference Address, 1. * Required
Reference Phone Number, 1. * Required
Reference Name, 2. * Required
Reference Address, 2. * Required
Reference Phone Number, 2. * Required

Part 9 of 15: Emergency
Emergency Contact * Required
Relationship * Required
Emergency Contact Home Phone * Required
Emergency Contact Work Phone * Required
Emergency Contact Address * Required

Part 10 of 15: Occupants
List All Occupants.
Occupant 1 * Required
Occupant 2
Occupant 3
Occupant 4
Occupant 5

Part 11 of 15: Pets
List Any Pets.
Pet 1 Type
Pet 1 Breed
Pet 1 Age
Pet 1 Weight
Pet 2 Type
Pet 2 Breed
Pet 2 Age
Pet 2 Weight

Part 12 of 15: Vehicles
List All Vehicles.
Vehicle 1 Type * Required
Vehicle 1 Make/Model * Required
Vehicle 1 Year * Required
Vehicle 1 License Plate * Required
Vehicle 2 Type
Vehicle 2 Make/Model
Vehicle 2 Year
Vehicle 2 License Plate
Vehicle 3 Type
Vehicle 3 Make/Model
Vehicle 3 Year
Vehicle 3 License Plate

Part 13 of 15: Credit
Bank Name * Required
Bank Address * Required
Checking Account Number * Required
Savings Account Number * Required
List All Credit Obligations With Minimum Monthly Payment.
1. * Required
2.
3.
4.
5.
6.
7.
8.
9.
10.

Part 14 of 15: Criminal History
Have any of the occupants listed above ever been:
Convicted of a felony? * Required
Received deferred adjudication for a felony? * Required
Been evicted? * Required
Broken a lease? * Required
Declared bankruptcy? * Required

Part 15 of 15: Statement

The above listed applicant declares that all statements made in this application are true and complete.
Applicant hereby authorizes the Landlords to verify all of the information in this application and obtain credit report(s) on the above listed applicant and/or applicants.
If applicant or applicant's spouse has given any false information Landlord is entitled to reject application, retain all application fees as liquidated damages for Landlord's time and expenses in processing this application.
Applicant shall give Landlord a nonrefundable application fee in the amount of $60 for a single person, or $100 for two people.
Signature of Applicant ___________________________________________________________________ Date _________________
Signature of Spouse ______________________________________________________________________ Date _________________
Signature of Landlord or Landlord's agent ________________________________________________ Date _________________

 



Contact Empire Rentals, LLC
empirerentals at comcast dot net
443-858-6003
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