Fillable Printable Minnesota Rental Application
Fillable Printable Minnesota Rental Application
Minnesota Rental Application
Page 1 of 4
07-2013
Minnesota Residential Lease Application
Property Address: Application Date: Move in Date Requested_____________
Application Processing Fee $___________How would you like this fee returned? If applicable _______Mail _______Destroying it _______Holding it for retrieval (1 day)
This fee is non-refundable should this application for rental be accepted or not.
INSERT “N/A” FOR NON-APPLICABLE ITEMS. ALL APPLICANTS MUST COMPLETE SEPARATE APPLICATIONS.
HOW DID YOU HEAR ABOUT US? __________________________________________________________________________________________________________
APPLICANT PERSONAL DATA (Please Print Clearly)
Complete Legal Name
Date of Birth
Driver’s License #
Social Security #
# Dependents
Phone Email
RENTAL HISTORY (account for all months of the past three years – use additional page if necessary)
From
To
Present
Complete Address (Including ZIP)
Rent Paid
$
Landlord Name
Phone #
Why Moving?
From
To
Prior Complete Address (Including ZIP)
Rent Paid
$
Landlord Name
Phone #
Why Moved?
From
To
Prior Complete Address (Including ZIP) Rent Paid
$
Landlord Name
Phone #
Why Moved?
EMPLOYMENT
From
To
Present
Employer Name & Address
Monthly Income
$
Position
HR Fax #
Phone #
Supervisor Name
From
To
Prior Employer Name & Address
Monthly Income
$
Position
HR Fax #
Phone #
Supervisor Name
OTHER HOUSEHOLD INCOME (Disability, Assistance, Child Support, Section 8, Etc. – You must list the name, phone number, AND fax number for each contact)
Source of Income
Complete Address (Including ZIP) Monthly Income
$
Contact Name
Fax #
Phone # Comments
Source of Income
Complete Address (Including ZIP) Monthly Income
$
Contact Name
Fax #
Phone # Comments
Source of Income
Complete Address (Including ZIP) Monthly Income
$
Contact Name
Fax #
Phone # Comments
Section 8
Complete Address (Including ZIP) Ve nd o r e d Amount
$
Worker Name
Fax #
Phone # Comments
TOTAL MONTHLY HOUSEHOLD INCOME $
SOURCE OF SECURITY DEPOSIT & FIRST MONTH RENT
Source of Security Deposit (bank account, agency, self)
Account # (checking / savings) Funds Now
$
Available
Contact Name
Phone #
Comments
Source of First Month Rent (bank account, agency, self)
Account # (checking / savings) Funds Now
$
Available
Contact Name
Phone #
Comments
AUTOS
Year, Make, Model
Color Payment
$
Paid to Whom
Phone #
Comments
Year, Make, Model
Color Payment
$
Paid to Whom
Phone #
Comments
PERSONAL REFERENCES
Name of Father and/or Mother
Complete Address (Including ZIP) Phone #
Comments
Personal Reference (no relatives)
Complete Address (Including ZIP) Phone #
Comments
In Case of Emergency Contact
Complete Address (Including ZIP) Phone #
Comments
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07-2013
DEPENDENTS
Name
Relationship to Applicant Age
Date of Birth Comments
Name
Relationship to Applicant Age
Date of Birth Comments
Name
Relationship to Applicant Age
Date of Birth Comments
Name
Relationship to Applicant Age
Date of Birth Comments
Name
Relationship to Applicant Age
Date of Birth Comments
PETS?
List for each animal: Species, Breed, Weight, Name, Age, & Sex
Have you ever had an eviction or U.D. filed against you? Yes No Have you ever been convicted of a crime? Yes No
Have you ever refused to pay rent? Yes No
Have you ever been asked to move? Yes No
You may be asked to provide more information if you answered “Yes” to any of the above questions.
APPLICANT ACKNOWLEDGEMENT, CERTIFICATION & AGREEMENT
I understand that this is an application for a legally binding lease agreement to occupy the above property. I understand that my application
will be evaluated objectively and that completion of an application and payment of a non-refundable Application Fee do not guarantee
acceptance of my application. By completing this application, I agree that if my application is accepted, I will promptly execute a lease
within the timeframe and at a location specified by MANAGEMENT. I understand that my security deposit will be due in full at lease
signing. If my security deposit is being paid by an agency, a written guarantee for the same must be faxed within 2 business days of
application approval. My first month’s rent must be paid in full before I can move in. Availability of the apartment being applied for cannot
be guaranteed unless the apartment is vacant. Apartment shall be considered available until MANAGEMENT has received payment for all
move-in costs and a signed lease with all contingencies removed.
I certify that all
I understand that my application will be evaluated using the following objective criteria:
information provided on this application is current, truthful, and correct. I understand that providing any false, misleading
or incomplete information on this application will cause my application to be denied and is grounds for eviction later if my application is
approved.
Rental History –
Minimum of two (2) years good rental history.
No eviction actions (unlawful detainers) within the past three (3) years
Credit History –
Credit must be satisfactory
Criminal History –
No felony convictions
No undesirable gross misdemeanor or misdemeanor convictions
Income Requirement –
Monthly household income (including vendored benefits) must exceed 2.5 times the monthly rent
Density –
Guidelines are two (2) persons per bedroom, subject to local ordinance.
MANAGEMENT reserves the right, with the property owner’s permission, to consider exceptions to rental criteria based upon supporting
information and/or documentation supplied by applicant demonstrating to MANAGEMENT’S satisfaction that such exceptions are justified
in evaluation the application.
Signature Date
For Office Use Only
Date Application Rec’d: _________________ Amount Accepted: $___________
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07-2013
WAIVER & RELEASE
I authorize the landlord and/or its agents to obtain all necessary information from the following
entities, individuals, and organizations for the purpose of verifying and evaluating the information for my initial
lease application, lease renewal, ongoing compliance with rental criteria, and/or to collect any outstanding amounts
due as a result of non-compliance with a lease:
• Employer(s)
• Landlord(s)
• Banking Institutions
• Creditors and/or Mortgagees
• References
• Department of Motor Vehicles
• Educational Institutions
• Credit reporting agencies
• Criminal record search for the states of:_____________________________________________________
• Federal Government agencies (including but not limited to the Social Security Administration and Public
Housing agencies)
• Minnesota Public Assistance agencies that sponsor programs in which I am or have been enrolled
• Other public or private housing assistance agencies to which I have applied for assistance
• Any other parties either listed on m y rental application or subsequently determined to be a source or
potential source of information to document or verify my income, assets, credit, residence address(es), or
other information useful for evaluation of my application and/or collecting outstanding debts owed.
Information from the following tenant screening service may be used to determine the acceptance or rejection of
your application: _____________________
_____________________
I agree to indemnify and hold harmless the landlord, its authorized agents, and all parties who release
information to the landlord in connection with the release, evaluation, and use of this information.
This waiver and release shall remain active and valid for as long as I lease from or have funds due to the landlord.
Signature Date
Social Security Number
Date of Birth
Page 4 of this document is a Receipt of Residential Lease Application Fee that is completed and given to the Applicant at the time of application.
Page 4 of 4
07-2013
Receipt of Residential Lease Application Fee
Date: __________________
From: _______________________________________________________ $____________
_________________________________________________________________________ Dollars
Cash Check Money Order
Accepted by: ____________________________________
(Signature)
