GEORGIA RENTAL APPLICATION FORM
1. Landlord Contact Information
If the applicant wishes to have more information about the rental unit, please contact
______________________________[Landlord Name] at:
Email Address: ____________________[Contact Email]
Phone: ____________________[Contact Phone]
2. Applicant Information
Name of Applicant: ______________________________[Name of Applicant]
Date of Birth: ____________________[Date of Birth]
Social Security Number: __________
Driver's license number or any valid ID: _________________
State: ______________ Expires: _________________________
Address: ______________________________[Applicant Address]
Email Address: ____________________[Applicant Email]
Phone: ____________________[Applicant Contact Phone]
3. Property Information
The property is located at the following address:
___________________________________________________________________________________
___________________________________________________________________________________
The property will be available for the potential Tenant to move in on ____________________[Date of
Availability].
The applicant proposes to move in on the following date:
☐
Date of Availability as assigned by the Landlord.
☐
Proposed move-in date on ____________________[Move-in Date].
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4. Lease Term
Type of Lease Term:
☐
Fixed Term [Fixed Term beginning on the ________ and ending on the ________].
☐
Month-to-Month
☐
Year-to-Year
☐
Unspecific
5. Payment
The applicant shall pay $ __________[Rent Amount] as rent. The rental payment shall be made as
follows:
☐
Weekly
☐
Monthly
6. Security Deposit
☐
The applicant shall pay an initial deposit in the amount of $ ____________________[Security
Deposit Amount].
☐
The applicant shall not pay any amount for a security deposit.
7. Other Occupant’s Information
Name: ____________________________________________________________________
Relation to Applicant: ______________________ Date of Birth: ______________
Name: ____________________________________________________________________
Relation to Applicant: ______________________ Date of Birth: ______________
Name: ____________________________________________________________________
Relation to Applicant: ______________________ Date of Birth: ______________
Name: ____________________________________________________________________
Relation to Applicant: ______________________ Date of Birth: ______________
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8. Application Fee
The Applicant shall pay a Non-Refundable Application Fee in the following amount of $
__________[Application Fee Amount].
This Non-Refundable Application Fee is not a deposit and does not apply toward rent unless specified,
should the applicant, after the qualifying process, be accepted as a Tenant. The application fee is to
cover the costs of qualifying the applicant as a prospective Tenant.
The applicant will pay the application fee through the following methods:
☐
Cash
☐
Credit Card
☐
Paypal
☐
Money Order
9. Previous Residence Information
Present Address: ______________________________[Present Address]
Duration of the Lease: years___________ months ____________
Payment: ____________________[Payment Amount]
Landlord Name: ______________________________[Landlord Name]
Telephone Number: ____________________[Landlord Telephone Number]
Previous Address: ____________________[Present Address]
Duration of the Lease: years___________ months ____________
Payment: ____________________[Payment Amount]
Landlord Name: ______________________________[Landlord Name]
Telephone Number: ____________________[Landlord Telephone Number]
10. Credit and Financial Information
1. Bank:
Account Type:
Account Number:
Branch Location:
2. Bank:
Account Type:
Account Number:
Branch Location:
3. Bank:
Account Type:
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Account Number:
Branch Location:
11. Emergency Contact
Emergency Contact Name: ______________________________[Contact Name]
Emergency Contact Address: ____________________[Contact Address]
Email Address: ____________________[Contact Email]
Phone: ____________________[Contact Phone]
Please state any further information you would like the owner/ agent to consider:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________.
Authority for Release of Information
This release will constitute my consent and authority to examine statements and information regarding
my background.
I authorize you to contact my/our present and previous landlords, law enforcement agencies, credit
agencies, and other references listed above.
I hereby authorize the release of any and all data or records to ______________________________
[Landlord Name].
This authorization is given in connection with a financial, criminal, and previous rental history
investigation being conducted relative to my/our application for credit dealing with rental property.
Signature of Applicant: ____________________ Date: ________
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