Fillable Printable Mississippi Rental Application

Mississippi Rental Application

MISSISSIPPI RENTAL APPLICATION

Neatly complete all information below. All applicants over the age of 18 must complete and sign their own application.

Applicants full name___________________________________Phone #___________________DOB__________

Social Security #_______________Drivers License #__________ State________ Exp.________

Current Address________________________________City___________________State________Zip_________

Current Landlords Name__________________________________Landlords Phone #______________________

How long at this address__________Reason for leaving______________________________________________

Previous Address________________________________City___________________State_______Zip_________

Previous Landlords Name__________________________________________Phone #______________________

How long at this address__________Reason for leaving______________________________________________

Auto Yr______Make____________Model_____________________State/License Plate #___________________

Present Employer_____________________________Position__________________Mo. Income_____________

Phone #__________________How long at job_________Other income/source____________________________

Employers Address_________________________________________City___________________State________

Number and type of Pets___________________________Have you ever been party to an eviction? ☐Yes ☐No

Name of bank_________________________Branch_____________________Type of

Account_______________

Name of bank_________________________Branch_____________________Type of

Account_______________

Personal References

Name______________________________Yrs. Known____ Relationship____________Phone #_____________

Total number of adults___________Total number of children living with you under the age of 18_____________

Names and relations of all other applicants_________________________________________________________

___________________________________________________________________________________________

I CERTIFY that answers given herein are true and complete to the best of my knowledge. I authorize __________

investigation of all statements contained in this application for tenant screening as may be necessary in arriving at

a tenant decision, I understand that the landlord may terminate any rental agreement entered into for any

misrepresentations made above.

Signature________________________________________________________________Date________________

Received from applicant the non-refundable sum of $____dollars to pay for tenant screening service.