Close

Log in to your account

Enter your username and password to log in

Username

 
Password

 





Managers Renters Pricing Questions? About Contact Sign Up
This is a sample online application that can be customized with our service. Please see some of the sample fields below, which you can edit or remove from your own custom template. You can also add text boxes, drop-downs, radio buttons, check boxes, date fields, and labels to your template.

123 Main Street Property

Rental Application for:

123 Main Street

Denver, CO 80206

Some required fields are not filled out. They are indicated in the form below.

Questions marked with * are required.

Required Identification Fields
* Required
Email is required. Email must be in a proper format.

First Name is required.

Last Name is required.
Middle Name * Required
Middle Name is Required
Phone Number * Required
Phone Number is Required
Date of Birth * Required
Date of Birth is Required
Current Residence:
Street Address * Required
Street Address is required.
City * Required
City is required.
State * Required
State is required.
Zip Code * Required
Zip Code is Required
Dates for Current Residence:
Start Date in Current Residence * Required
Start Date is Required
End Date in Current Residence, if applicable
Present Landlord
Present Landlord Phone
Present Rent
Previous Residence:
Address
City
State
Zip Code
Dates of Previous Residence:
Start Date of Previous Residence
End Date of Previous Residence
Previous Landlord
Previous Landlord Phone Number
Previous Rent Amount
Additional Occupants:
Additional Occupant #1 Name
Additional Occupant #1 Relationship
Additional Occupant #1 Occupation
Additional Occupant #1 Age
Additional Occupant #2 Name
Additional Occupant #2 Relationship
Additional Occupant #2 Occupation
Additional Occupant #2 Age
Additional Occupant #3 Name
Additional Occupant #3 Relationship
Additional Occupant #3 Occupation
Additional Occupant #3 Age
Additional Occupant #4 Name
Additional Occupant #4 Relationship
Additional Occupant #4 Occupation
Additional Occupant #4 Age
Please list any additional Occupants, if applicable (Name, Relationship, Occupation, Age)
Do you have any Pets? * Required
Please confirm if you have any Pets
If Yes, please list each pet (Type, Weight, etc.)
Please list any vehicles you have (Vehicle Year, Make, Color, License #, State)
Current Employer:
Employer Name * Required
Employer Name is Required
Position
Hours worked per week
Your Manager's Name
Manager's Phone Number and Extension
How long have you worked at this company?
Employer Address
Employer City
Employer State
Employer Zip
Income:
Annual Salary/Wages
Annual Salary of Co-applicants, if any
Additional Income
Total Anticipated Annual Income
Is there any additional information we should know?
Other Questions:
Have you ever been convicted of a felony? * Required
Please confirm Yes/No
Have you ever filed for bankruptcy? * Required
Please confirm Yes/No
Do you smoke? * Required
Please confirm Yes/No
Have you ever been evicted from a tenancy? * Required
Please confirm Yes/No
Have you ever moved owing rent or damaged a rental? * Required
Please confirm Yes/No
More Required Identification Fields
Legal Text
Applicant authorizes the landlord/property manager to contact current and former landlord(s) or property manager(s), employers, creditors, credit bureaus, neighbors and any other sources deemed necessary to investigate applicant. All information above is true, accurate, and complete to the best of applicant’s knowledge. The landlord/property manager reserves the right to disqualify tenant if information is not represented.

Signing my full name in the following field qualifies as my legally binding signature per the Uniform Electronic Transactions Act (UETA).
Type Signature * Required
Signature is required.


Some required fields are not filled out. They are indicated in the form above.




Home | Managers | Renters | Questions? | About | Contact
© 2004 - 2025 eRentPayment. All rights reserved. Terms of use.