TERMS: APPLICANT CERTIFIES THAT ALL INFORMATION GIVEN TO EVALUATE NTN MEMBER NAME: ACCESS NUMBER:
THIS APPLICATION TO RENT / LEASE IS CORRECT AND COMPLETE. APPLICANT
AUTHORIZES ALL INQUIRIES BY RENTAL OWNER, OWNER’S AGENT OR NATIONAL
TENANT NETWORK DEEMED NECESSARY TO EVALUATE THIS APPLICATION.
APPLICANT FURTHER UNDERSTANDS THAT ANY FALSE , INACCURATE, OR TELEPHONE: FAX:
INCOMPLETE INFORMATION IS GROUNDS FOR IMMEDIATE REJECTION. APPLICANT
SPECIFICALLY AUTHORIZES AND REQUESTS ALL PRESENT AND PREVIOUS
CONTACT: DATE: TIME:
EMPLOYERS, MORTGAGE HOLDERS, LANDLORDS, RENTAL AGENTS, CREDIT
GRANTORS, BANKS, ACCOUNTANTS, STOCK BROKERS, AND ANY GOVERNMENT REPORTS FOR:(Please Specify) Applicant Spouse
AGENCY TO RELEASE ANY REQUESTED INFORMATION IN THE EVALUATION OF
THIS APPLICATION. THIS FORM IS PROVIDED BY NTN TO ASSIST ITS MEMBERS IN REPORT TYPE(S): CREDIT EVICTION
PROCESSING THEIR APPLICATIONS TO LEASE RENTAL PROPERTY. NTN SHALL DECISION POINT PLUS NATIONWIDE CRIMINAL
NOT BE RESPONSIBLE FOR THE USE OR APPLICATION OF THIS FORM BY OTHERS OR STATEWIDE CRIMINAL: STATE________________
ANY LEGAL ASPECT AS TO A LEASING / RENTAL AGREEMENT ENTERED INTO BY FULL SERVICE(Credit, Eviction, Nationwide Criminal,
ANY PARTIES USING THIS FORM. Employer / Landlord Verifications)
Application
USE BLACK INK AND PLEASE PRINT CLEARLY! VERIFY I.D. / SSN / ADDRESS INFO!
Applicant: SSN# / / .
LAST FIRST MIDDLE
DOB: ________/_______/_________ Contact Info: Cell Phone: Work Phone: __________________________
Others who will occupy premises: _________________________________________ Will pets be residing in the residence? Yes or No
Present Address: _______________________________________ Rent Amt: $_________ Reason for Leaving:
City: __________________________________________ State: _______ Zip: __________ Your Home Phone: ( )
Current Landlord: _________________________________________ Phone: ( )____________________Date From_____________ to ________________
Previous Address: __________________________________________ Rent Amt: $ ____________ Reason for Leaving:______________________________
City: _____________________ State: _______ Zip: __________ Has an eviction ever been filed against you? Yes / No
Previous Landlord_________________________________________ Phone: ( )____________________Date From_____________ to ________________
Present Employer: ___________________________________________________________ Main Phone: _____________________________________________
Position: ______________________________________________________________Human Resource Contact: _______________________________________
Date From: _____________ to ____________________Gross Income: $ per week[ ] month[ ] yr[ ] Other Income:___________________
Previous Employer: ______________________________________________________Main Phone #: ( )___________________________________
Emergency Contact: _____________________________________ Relationship to Applicant: ___________________________________________
Emergency Contact Home Phone: _____________________________ Emergency Contact Cell Phone: _____________________________
Bank Name: _________________________ Account Type: Checking or Savings Account Number: _____________________________________
Bank Name: _________________________ Account Type: Checking or Savings Account Number: _____________________________________
Auto make_____________________________ Yr__________ Tag #______________ Owned?: Yes / No Leased?: Yes / No
Auto make_____________________________ Yr__________ Tag #______________ Owned?: Yes / No Leased?: Yes / No
If I rent the unit, I understand my rental history including lease violations and information I provide on this application may be reported to
and maintained by National Tenant Network for up to 7 (seven) years after I vacate the premises.
Applicant Signature: Date:
