Fillable Printable Louisiana Rental Application

Louisiana Rental Application

Applicant

Information

Name:

Phone:

Date of birth:

Dr License:

Current address:

Contact:

Phone:

☐ Own ☐ Rent (Please check)

Monthly payment or rent:

How long?

Previous address:

Contact:

Phone:

☐ Owned ☐ Rented (Please check)

Monthly payment or rent:

How long?

Previous address:

Contact:

Phone:

Employment

Information

Current employer:

Employer address:

How long?

Phone:

E-mail:

Fax:

Position:

☐ Hourly ☐ Salary (Please check)

Annual income:

Emergency

Contact

Name of a person not residing with you:

Address:

City:

State:

ZIP Code:

Phone:

Relationship:

Co-applicant

Information

Name:

Phone:

Date of birth:

Dr. License:

Current address:

Child:

(If different)Previous address:

Contact:

Phone:

☐ Owned ☐ Rented (Please check)

Monthly payment or rent:

How long?

Co-applicant Employment

Information

Current employer:

Employer address:

How long?

Phone:

E-mail:

Fax:

Position:

☐ Hourly ☐ Salary (Please check)

Annual income:

References

Name:

Address:

Phone:

I authorize the verification of the information provided on this form as to my credit and employment. I have received a copy of this

application.

Signature of applicant:

Date:

Signature of co-applicant:

Date: