ANN LAMPERT REALTY, INC.
420 S. Forest St.
Denver, CO 80246
RENTAL
APPLICATION
303-388-2437
303-388-7494 FAX
Notice: Co-Applicant must complete a separate Rental Application Form
DATE:______________________________________
The undersigned hereby makes application to rent for the period of__________________ to __________________ the
property located at ___________________________________________________ unit number ________________
at a monthly rental of $ _________________ Security Deposit $________________ Rent to Start $________________
How did you hear about residence ___________________________ Desired Move-In Date ______________________
PLEASE TELL US ABOUT YOURSELF
FULL NAME _____________________________________________________________________________________
Present Address __________________________________________City____________State_______Zip_________
Home Phone (
Cell Phone (
) ___________________________ Work Phone (
) ___________________________
) __________________________ E-mail ____________________________________________
Date of Birth ________________________________ Social Security No. _____________________________________
Driver’s License/ID Number ________________________________ State ____________ Expiration______________
Name of Co-Applicant ____________________________________________________________________________
Present Address ___________________________________________City____________State_______Zip__________
Home Phone (
Cell Phone (
) ___________________________ Work Phone (
) ___________________________
) __________________________ E-mail ____________________________________________
Date of Birth __________________________________ Social Security No. ___________________________________
Driver’s License/ID Number ________________________________ State ____________ Expiration______________
List Everyone, Including Children, Who Will Live With You:
Name
Relationship to Applicant
Age
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
Do You Own an Animal? No__ Yes__ Is it a guide or service dog? No__ Yes__ PET DEPOSIT $______________
What type/color?____________________________________________ Weight: ___________________
Do You Smoke? No____ Yes____
Please List Two References (NO RELATIVES) Who Know You:
Name/Relationship
Address
Phone Number
________________________________________________________________________________________________
________________________________________________________________________________________________
PLEASE GIVE YOUR RESIDENCE HISTORY FOR THE PAST 3 YEARS (Beginning With Most Current)
CURRENT ADDRESS _________________________________________________________Rental rate $__________
Month & Year Moved In ______________________ Reason for Leaving _______________________________
Owner or Agent ________________________________________ Phone (
) ____________________
PREVIOUS ADDRESS_________________________________________________________Rental rate $__________
Month & Year Moved In ______________________ Reason for Leaving _______________________________
Owner or Agent ________________________________________ Phone (
) ____________________
PREVIOUS ADDRESS_________________________________________________________Rental rate $__________
Month & Year Moved In ______________________ Reason for Leaving _______________________________
Owner or Agent ________________________________________ Phone (
Updated: December 19, 2014
) ____________________
PLEASE GIVE YOUR EMPLOYMENT INFORMATION
STATUS:
___Employed Full-Time ___Employed Part-Time ___Student ___Retired ___Unemployed
EMPLOYER ;
____________________________________________________________________________
Date(s) Employed _________________________________ Employed as ____________________________________
Supervisor _________________________________________ Supervisor Phone (
) ____________________
Address ___________________________________________________City____________State_______Zip_________
Salary $_________________________ per _______________, hours per week__________
If employed less than 6 months, give name and address of previous Employer or School:
______________________________________________________________________________________________
If there are other sources of income you would like us to consider, please list income, source and person
(Banker, Employer, etc.) who we could contact for confirmation. You do NOT have to reveal alimony,
child support or spouse’s annual income unless you want us to consider it in this application.
Amount $ ______________________________ Source __________________________________________________
PLEASE LIST YOUR BANK AND CREDIT REFERENCES
YOUR BANK(S)
Checking/Savings
City/State
Branch
Type of Acct
1. ____________________________________________________________________________________________
2. ____________________________________________________________________________________________
CREDIT REFERENCES/PAYMENTS OWED
City/State
Balance
Payment
(credit cards, student loans, etc…)
1. ____________________________________________________________________________________________
2. ____________________________________________________________________________________________
3. ____________________________________________________________________________________________
YOUR VEHICLE MAKE/MODEL _________________________ Year _________ Tag No. ____________State ______
Is there a loan? No___
Yes___ Loan Company______________________________ Payment $____________
SECOND VEHICLE MAKE/MODEL _______________________ Year _________ Tag No. ____________State ______
Is there a loan? No___
Yes___ Loan Company______________________________ Payment $____________
OTHER VEHICLES _______________________________________________________________________________
DOES YOUR PRESENT LANDLORD KNOW YOU ARE LEAVING?
HAVE YOU EVER: Filed for bankruptcy?
No___
Been evicted from a tenancy?
Yes___
No___
Yes___
Yes___
No___
Yes___
Willfully or intentionally refused to pay rent when due?
Do you owe any unpaid rent?
No___
No___ Yes___ If yes, how much? __________________
Been convicted of a crime (other than a minor traffic offense)?
If yes, when? _____
Offense? _______________
No ____ Yes____
IN CASE OF EMERGENCY, NOTIFY _________________________________________________________________
(a person that does not live with you)
Relationship ____________________________________ Phone (
) ___________________________
Address __________________________________________________________________________________
Please give any additional information which might help management evaluate this application: ____________________
_______________________________________________________________________________________________
______________________________________________________________________________________________
I certify that all the information given is true and correct and understand that my lease or rental agreement may be
terminated if I have made any false or incomplete statements in this application. I authorize verification of the
Information provided in this application from my credit sources, current and previous Landlords and employers,
and personal references.
DEPOSIT AND PHOTO I.D. REQUIRED TO PROCESS THIS APPLICATION. PLEASE BRING THESE WHEN YOU
TURN IN THE APPLICATION. DEPOSIT TO BE FULLY REFUNDED IF APPLICATION DENIED.
Signature of Applicant ____________________________________________________ Date ____________________
XCEL Called: ____________ Read Date: ____________ WATER Called: ____________ Read Date: _____________
Owner OK: ____________________________________ Tenant OK: _______________________________________
Updated: December 19, 2014