California association of realtors application to rent fillable pdf

i~.

CALI

FORN

IA

.~

ASSOC

I

AT

I

ON

•

.,

OF

REALTORS

®

APPLICATION TO RENT/SCREENING

FEE

(CAR.

Form

LRA,

Revi

sed

'1

113)

I.

APPLICATION

TO

RENT

THIS SECTION

TO

BE

COMPLETED BY APPLICANT. A SEPARATE APPLICATION TO RENT

IS

REQUIRED FOR EACH

OCCUPANT 18 YEARS

OF

AGE OR OVER, OR AN EMAN

CI

PATED MINOR.

1.

Applicant

is

completIng

Application

a8 a (check one)D tenant, Dtenant

with

co-tenant(s) orO guarantor/co-signor.

Total number

of

applicants".

__________________________

_

_____

_

2.

PREMISES INFORMATION

Application to rent property at

Rent: $

3.

PERSONAL INFORMATION

per

., , ("Premises")

Proposed

move-in

date

A. FULL

NAME

OF

APPLICANT

____

-,:,-

__

---;..,.,...,...,_---,,,-

_.,-:--..,,.-..,...,.-.,,-..,.-_

,.,,.,=~___,

B.

Date

of Birth (For purpose

of

obtaining credit reports. Age discrimination

is

prohibited

by

law.)

C.

Social Security

No

. Driver's license

No

.

____

_____________

_ _

Siale

__

Expires

O. Phone Number: Home

E.

Email

Work

Other

F

o.

Name(s)

of

all

other proposed occupant(s) and relalionship

10

applicanl

10

5.

EMPLOYMENT

AND

INCOME HISTORY

C

urrent

employer :-:;==

__________

_

Current employer address

From

To

supervisor~~;;;;~;:::=====~~===

Supervisor phone

Employment

gross income $ per

Other

income

i

nfo

___

____

__

____

_

The

copyright laws

or

the

United

States

(T

We

t7

U.S. Code)

rorbld

the

unautOOrtzed

reproduction

01

this form.

or

any portion

thereof

. by photocopy

machine

or

any

other

means

. Including lacsimile

or

computerized

formats

.

Cop)'rightC

1~1-2013

.

CALIFORNIA ASSOCIATION

OF

REALTORS®,

INC

.

ALL

RIGHTS

RESER

V

ED

.

LRA

RE

VISED

11

113

(PAGE 1 OF 2)

Year

license

No.

State

Color

Previous address

_____________

_

Ci~/S~la~le~Q~iP~~~~~~~~~~~~~~~~

From

to

Name

of

Landlord/Manager

Landlord/Manager's phone

Did

you

own

this property? 0

No

0

Yes

Reason

for

leaving

this

address

Previous

employer,-

____________

_

Prevo

~jmjP;IO~Y;erj.~djd~rejSjs~~~~~~~~~~~~

Fr

om

To

Supervisor

Supervisor

phone

Employment

gross income $ per

Other income

info

Applicant. Initials (

___

I t

__

_

D.~

--

-

APPLICATION

TO

RENT/SCREENING FEE (LRA PAGE 1

OF

2)

CENTURY 21 Mammoth Realty - (760) 914-2121

PropertyAddress: •

••

~

.

____________

_________

__________

Date: _

______

_

6 CREDIT INFORMATION

Name

of

creditor

Account number

Monthly payment Balance due

Name

of banklbranch

Accounl number Type

of

account

Account balance

7. PERSONAL REFERENCES

Name

Phone

Name

Phone

Address,

-=====:::<lC<:uj)ati.;;;-================

length of acquaintance _ Occupation

Address,

-=====:::<lC<:uj)ati.;n================

length

of

acquaintance _ Occupation

8.

NEAREST RELATlVE(S)

Name

_______________

____

________

JAddressc-~-------------------------------------------

Phone

Relationship

_______________________

_

Name

Address ;:;;;sh;P:

=======================-_

Phone Relationship

Applicant understands

and

agrees that:

(i)

this is

an

application

to

rent only

and

does not guarantee that applicant will

be

offered the

Premises; (ii)

landlord or Manager or Agent may accept more than one application for the Premises

and,

using their sole discretion,

will select the

best

qualified applicant, and (Iii) Applicant

will

provide a copy

of

applicant's driver's license upon request.

Applicant represents the above information

to

be

true

and

complete,

and

hereby authorizes Landlord or Manager or Agent

to

: (i) verify

the

information provided;

and

(Ii) obtain a credit report

on

applicant

and

other reports, warnings and verifications

on

and about

applicant,

which

may

include, but

not

be

limited to, criminal background checks, reports

on

unlawful delainers,

bad

checks, fraud

warnings, employmenl

and

tenant history. Applicant further authorizes Landlord or Manager or Agent

10

disclose information

to

prior or

subsequent

owners

andlor agents.

If appiJcation is not fully completed,

or

re

ceived without the screening fee:

(i)

the application will not

be

processed, and (ii) the

appli

ca

tion and any screening fee will

be

returned.

Applicant Dale Time

_____________

_

Return your completed

application and any applicable fee nol already paid

to

:

-=====

===

~:aiE

>::

=

::::

liP

-======

Address City

________

__

_________

Stale Zip

II.

SCREENING

FEE

THIS SECTION

TO

BE COMPLETED BY LANDLORD, MANAGER

OR

AGENT.

Applicant has

paid

a nonrefundable screening fee of $ , applied

as

follows: (The screening

fee

may

not

exceed

$30.00, adjusted annually

from

1-1-98 commensurate with

the

inc

rea

se

in

the Consumer Price Index. A

CPI

inflation

calculator

is

available

on

the Bureau of Labor Statistics website, www.bls.gov.

The

Ca

lifornia Department of Consumer Affairs

calculates the applicable screening fee amount

to

be

$42

.06

as

of

2009

.)

$ for credit reports prepared

by

_________________

--,

==

===:;;::;-:::===-=

$ for (other out-of-pocket expenses); and

$ for processing.

The

undersigned has read Ihe foregoing

and

acknowledges receipt of a copy.

Appilcant

Sign

ature

Dale

The

undersigned has received the screening fee indicated above.

~~~~

__

~~~~

___________

--,CaIBRE Uc.

#,

_

_____

~

-----

Landlord

or

Manager

or

Agent Signature

Date

The

copyright

laws

of

the

Un

i

ted

States

(Title

17

U.S.

COde)

forbid

the

unauthorized

reproduction

of

this

form,

or

any

portion thereol.

by

photoc::opy machille

or

any

other

means

. i

ncfuding

facs

lmne

or

computerized

formats

.

Copyright

C

1998-2013,

CALIFORNIA

ASSOCIATION

OF

REAL

TORS®,

INC

.

ALL

RIGHTS

RESERVED

.

THIS

FORM

HAS

BEEN

APPROVED

BY

THE

CALIFORNIA

ASSOCIATION

OF

REALTORS®

(CAR

.

).

NO

REPRESENTATION

IS

MADE

AS

TO

THE

LEGAL

VALIDITY

OR

AOEQUACY

OF

ANY

PROVISION

IN

ANY

SPEC

I

FIC

TRANSACTION

. A

REAL

ESTATE

BROKER

IS

THE

PERSON

aUALIFIED

TO

AOVISE

ON

REAL

ESTATE

TRANSACTIONS

.

IF

YOU

DESIRE

LEGAL

OR

TAX

AOVICE

,

CONSULT

AN

APPROPRIATE

PROFESSIONAL.

Th

l.

form

It

ava

ilable

lor

use

by

the

entire

real

estate

Industry

.

II

is

not

Intentled

10

id8f1tf)!

the

user

as

a

REALTORCI

.

REALTORCI

Is

a

registered

collectiVe

membeBhlp

mar\(

WhIch

may

be

used

only

by

memboB

of

the

NATIONAL

ASSOCIATION

OF

REAL

TORS«!

who

SlIbsaibe

10

Its

Code

of

Ethics.

•

REAL

ESTATE

BUSINESS

SERVICES

,

INC

.

[]

Published and

OIsb1butad

by.

a

.sub$id

iary

of

the c.lifomllJ AssocflJfiM

of

REAL

TORStIP

••

525

South

VIrgil

Avenue.

Los

Angeles.

California

&0020

LRA REVISED 11/13 (PAGE 2 OF

2)

1

ReVIewed

by

APPLICATION TO RENT/SCREENING FEE (LRA PAGE 2 OF

2)

Date

click to sign

signature

click to edit

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