Rental Application

Please note you have a choice to use the secure online form below or download a pdf of the Rental Application CLICK HERE, fill it in, sign it and fax it to: 805 966-6858

Date*

Name of Applicant*

Date of Birth*

Phone #*

Social Security #

Driver's License #*

Email Address*

Present Address*

City*

State*

Zip*

How long at present?*

Prior Address*

Prior City*

Prior State*

Prior Zip*

How long at prior?*

Name of Landlord*

Landlord's phone #*

Prior Landlord*

Prior Landlord's Phone #*

How many will be living in this unit?

Adults*

Children

Pets

Pet's type/size

Employment

Employer*

Occupation*

Current Salary*

How Long*

Contact Person*

Contact Phone #*

Spouse Information

Name of Spouse

D.O.B.

Spouse Phone #

Social Security #

Driver's License #

Spouse Employer

Spouse Current Salary

Spouse How Long?

Spouse Contact Person

Spouse Contact Phone #

Bank Information

Bank Name*

Bank Branch

Bank Phone #*

Bank Address*

Checking Acct. #*

Savings Acct. #

Personal References

Reference Name(1)

Reference Relationship(1)

Reference Telephone(1)

Reference Name(2)

Reference Relationship(2)

Reference Telephone(2)

Reference Name(3)

Reference Relationship(3)

Reference Telephone(3)

Other Information

# of vehicles (include company cars)

Make/Model(1)

Year(1)

color(1)

Tag No.(1)

State(1)

Make/Model(2)

Year(2)

Color(2)

Tag No.(2)

State(2)

Make/Model(3)

Year(3)

Color(3)

Tag No.(3)

State(3)

Have you Ever:

Filed for bankruptcy*

If yes, when?

Been served an eviction notice or asked to leave a property you were renting?*

Willfully or intentionally refused to pay rent when due? *

If yes, when?

Been sued for unlawful detainer?*

How were you referred to us?

Address of rental unit applied for*

Commencement date*

Term

Monthly rent

Disclosers

RADON GAS Notice to Prospective Tenant: Radon is a naturally occurring radioactive gas that, when it has accumulated in a building in sufficient quantities, may present health risks to persons who are exposed to it over time. Levels of radon that exceed federal and state guidelines have been found in buildings in every state. Additional information regarding radon and radon testing may be obtained from your county public health unit.

LEAD PAINT Every purchaser of any interest in residential real property on which a residential dwelling was built prior to 1978 is notified that such property may present exposure to lead from lead-based paint that may place young children at risk of developing lead poisoning. Lead poisoning in young children may produce permanent neurological damage, including learning disabilities, reduced intelligence quotient, behavioral problems and impaired memory. Lead poisoning also posed a particular risk to pregnant women. The seller of any interest in residential real estate is required to provide the buyer with any information on lead-based paint hazards from risk assessments or inspection in the seller’s possession and notify the buyer of any known lead-based paint hazards. A risk assessment or inspection for possible lead-based paint hazards is recommended prior to purchase.

Acknowledgment

I/We refererenced below as Applicant and CO-Applicant understand that Preferred Rental Services is the leasing agent and representative for the owner/landlord and that the leasing agent’s fees will be paid by the owner/landlord. The Applicant and CO-Applicant acknowledge that this written notice was received prior to Applicant and CO-Applicant receiving a lease agreement.

Applicant*

Co-Applicant

Date *

Consent to obtain credit/employment information

By submitting this form, I/We authorize Preferred Rental Services to investigate my/our credit qualifications and hereby release, in any manner all of the information obtained by you. I/we further release all persons, agencies, or firms from all liabilities resulting from providing such information. I/We declare under penalty of perjury that the information listed in this application is true and correct.

Submitted on this date*

In the city of*

State of *

Applicant's first and last name*

Co-Applicant's first and last name

By checking the "I agree" box below, I acknowledge that I am the applicant referenced in both the Acknowledgment and Consent sections above and understand that this is a legally binding agreement.

I Agree

Preferred Rental Services, Santa Barbara