Application for Rental House

SERVICE ANIMAL & ESA – REQUIREMENTS

Did you pay the APP Fee?? --> Application will NOT be processed until your App Fee is Paid. *

Application Date *

Which Rental House are you apply for? (Just because a Rental House is listed below DOES NOT mean it is available to rent at this time - you must speak to Power Real Estate to verify availability) *

Have you seen this Rental House in person yet? *

I/We have only seen the outside of the house
I/We have been shown the inside of the house
I/We have not seen this house in person yet

--->> AN APPLICATION MUST BE FILLED OUT FOR EVERYONE AGE 19 YRS AND OLDER THAT WILL BE LIVING IN THE RENTAL HOUSE --> Regardless of whether they will be on the Lease or not, whether they will live there part-time or full-time, short-term or long-term --> Anyone that stays there more than 3 days a month is considered an Occupant/Tenant and NOT a Visitor --> Any Additional Occupants/Tenants, whether now or in the future, that do not submit an Application and are not approved by the Lessor, is grounds for Eviction of ALL Occupants/Tenants without proration of rent or refund of security deposit. *

I/We Understand and Agree that I/we must submit an Application for everyone Age 19 Yrs and Older.
I/We Understand and Agree that failure to have any Additional Occupants/Tenants complete an Application and be approved by the Lessor, whether now or in the future, is grounds for Eviction of ALL Occupants/Tenants without proration of rent or refund of security deposit

(Our application form accepts up to 4 applicants in one submittal. If you have more than 4 applicants that are 19 Yrs and Older, then when you are finished submitting the first application form with 4 applicants, you will need to come back to this site and submit another application form for your remaining applicants)

TOTAL NUMBER OF OCCUPANTS AGE 19 AND OLDER *

========== APPLICANT # 1 ========== *

First

Middle

Last

Martial Status *

Married
Single

Social Security # (No Dashes) *

Birth Date *

Drivers License # AND STATE it's issued by *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Cell Phone --> MUST have different Cell Phone than other Applicants or Application will NOT be approved *

Home Phone *

Work Phone *

Email Address --> MUST have different Email Address than other Applicants or Application will NOT be approved *

Confirm Email

YOU AND ONLY YOU - NOT INCLUDING ANYONE ELSE IN YOUR HOUSEHOLD - Monthly Income - After Taxes *

===== APPLICANT # 1 - List someone 19 Yrs or Older that DOES NOT live with you as a Personal Reference *

First

Last

** All information is required, as we may contact the individual you have listed as a Personal Reference as part of our consideration process.

What is their Relation to you? *

Cell Phone *

Home Phone *

Email Address *

Confirm Email

Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

======== BANKING INFORMATION

Name of your Bank *

City & State of your Bank *

First

Last

What kinds of bank accounts do you have? *

Checking
Savings
Other

Are you willing to let us draft your Rent payment each month? *

Certainly - Not a Problem
Possibly - I/We will Consider It
Hard Pass - No Thank You

======== YOUR CURRENT LIVING SITUATION

Do You: *

Own a Home
Rent
Live with Family
Other

How long have you been at this address: *

How much do you pay per month for Housing? *

======== MINOR AGE OCCUPANTS - Children

How many children UNDER THE AGE OF 19 YRS will be living in the Rental House ---> Regardless of whether they will be there part-time or full-time, short-term or long-term ---> This includes split custody situations, if the child will stay with you at all, they must be listed *

======== PETS / ANIMALS

PETS / ANIMALS --> Whether I currently have pets/animals, or will have pets/animals in the future - I am aware that there is a Leash Law and agree to abide by all City, County, State, Goverment Laws and Regulations pertaining to owning a pet/animal, including but not limited to, proper vaccinations, containment, shelter, etc; as well as any Rules or Regulations dictated by any HOA that may be active in my neighborhood; so my pets/animals do not become a nuisance or danger to my neighbors. *

I/We Understand and Agree to abide by all Laws, Rules & Regulations concerning my Pets/Animals

FUTURE PETS / ANIMALS --> I understand that if I acquire any pets/animals in the future; whether caged, indoor or outdoor; I MUST contact the Landlord prior to acquiring the pet/animal for Landlord's approval and a Non-Refundable Pet Fee will be required at that time. *

I/We Understand and Agree that any future pets/animals must be approved by Landlord and a Non-Refundable Pet Fee will be required

HOUSEHOLDS WITH PETS / ANIMALS --> I understand that if I gain approval for my pets/animals, that not all pets/animals will be approved to be indoors. Any damages done by pets/animals whether indoors or outdoors are the responsibility of the Occupants/Tenants; this includes but is not limited to, friends/family bringing pets/animals to the home or any neighboring or stray pets/animals that the Occupants/Tenants allow in/on or around the property. *

I/We Understand and Agree that if my/our pets/animals are approved as an outside pets/animals, that it/they will remain outside and will not be brought inside the home under any circumstance
I/We Understand and Agree that I/we will be responsible for all damages inside and outside for all pets/animals on the property whether they are mine/ours or not --> this includes, but is not limited to, my/our family/friends/neighbors pets/animals and any strays that I/we allow in/on or around the property
I/We Understand and Agree that the Pet Fee is Non-Refundable and I/we will not be refunded any portion of it
I/We Understand and Agree that I/we must pay a Pet Fee regardless if the Pets/Animals is/are caged, indoors or outdoors and whether they will be there part-time or full-time, short-term or long-term
I/We Understand and Agree that Landlord's Insurance restricts specific Pets/Animals, therefore I/we will be honest and forthcoming in listing all my/our current Pets/Animals that I/we own and I/we will contact Landlord prior to acquiring any additional Pets/Animals in the future

How many Pets/Animals in total will be living in/on the property regardless if caged, indoors or outdoors? *

======== SERVICE ANIMAL OR ESA ANIMAL

======== VEHICLE INFORMATION

How many licensed drivers in the home? *

How many Cars, Trucks, Motorcycles will be on the property? (Specify) --> All vehicles on the property MUST be in running order. NO inoperable vehicles are allowed. *

How many will be on the property: UTILITY / CARGO OR OTHER TYPES OF TRAILERS (Specify) *

How many will be on the property: CAMPERS / RV'S (Specify) *

Campers / RVs are NOT to be lived in at all while on the property. They may only be on the property as a stored vehicle, NOT for additional living quarters. They MUST be stored in the Back Yard. You MAY NOT empty disposal tanks onto the property. *

I/We Understand and Agree to abide by the stipulations set out above concerning Campers / RVs

Please specify the TYPES of recreational vehicles and HOW MANY will be on the property: BOATS / JET SKIS / 4-WHEELERS / DIRT BIKES / BOONIE BIKES / GO-CARTS / GOLF CARTS, ETC ---> Recreational Vehicles MAY NOT be used on the property; in the neighborhood or surrounding neighborhoods/properties, unless they are a properly registered, road approved vehicle with a plate/tag from the DMV. This includes, but is not limited to 4-Wheelers, dirt bikes, boonie bikes, go-carts, golf carts, etc. Any damages caused to the property or neighborhood will be the sole responsiblity of the Renter. Family, friends and guests of the Renter are held to these same standards, and the Renter will be held responsible for all family, friends and guests actions. *

Regardless if I currently own any recreational vehicles or if in the future I acquire any recreational vehicles: *

I/We Understand and Agree to abide by the stipulations set out above concerning Recreational Vehicles

Large Oversized Heavy or Commercial Vehicles including, but not limited to: RV, Big-Rig, 18-Wheeler, Delivery/Box Truck, School Bus, City or County Vehicle, Squad Car, Etc *

No - I/We do not currently own or operate such a vehicles
Yes - I/We currently own or operate such a vehicles

Whether I currently have, or will have in the future - the above mentioned Large Oversized Heavy or Commercial Vehicles: *

I/We Understand and Agree that I/we need to make every effort not to disturb my/our neighbors with noise issues from such vehicles, or become a nuisance in any way by blocking traffic, mailboxes, etc and I/we will enter and exit the neighborhood in a respectful manner being cautious for all children and animals
I/We Understand and Agree that I/we may not park my/our large, oversized, heavy or commercial vehicles on the side of the road or on another property in the neighborhood, regardless if it is short-term or long-term
I/We Understand and Agree that I/we will be responsible for all damages caused from having this type of a vehicle in the neighborhood, such as, but not limited to, road damages, culvert damages, landscaping damages, sprinkler damages, septic damages, etc - regardless if the vehicle is my/our own personal vehicle or owned by my/our employer or someone else. I/we assume all liability by having this type of vehicle in the neighborhood and will be responsible for the cost of all repairs.

======== BANKRUPTCY INFORMATION

Are you, your spouse, significant other or a member of your houshold currently in Bankruptcy, or have filed in the last 7 years? *

======== RENTAL HOUSE ARTICLES

1) "SMOKE-FREE" --->> All Rental Houses are designated as a "Smoke-Free" living environment. This means that no Occupants/Tenants, their family, friends or visitors may smoke inside the home, inside the garage, on the porch or under the porch overhangs. This includes but is not limited to any form of Fire Lit Smoking Device, E-Device, or Vape. ---> Violation of this designation will result in forfeiture of security deposit as well as possible additional charges for damages and/or repairs, such as but not limited to repainting entire interior of home & carpet cleaning. *

I/We Understand and Agree to the Smoke-Free designation of the Rental House and that I/we will automatically forfeit my/our security deposit if I/we allow anyone to violate this designation
I/We Understand and Agree to properly dispose of all smoking paraphernalia and it will not be left on porches or in yards

2) HOME BUSINESS STIPULATION --->> Occupants/Tenants/Family/Friends may not run any type of business from the Rental House location, inside, outside or anywhere on the property. This includes, but is not limited to, daycare/childcare/sitter, mechanic/machinist/welder/carpenter, hairdresser/beautician/cosmetologist, animal breeder/boarder/rescue, etc etc *

I/We Understand and Agree that I/we will abide by the stipulation set above that no Home Business of any type will be run from the Rental House location, inside, outside or anywhere on the property.
I/We Understand and Agree that if I/we violate this Home Business stipulation, that it is grounds for Eviction with no proration of rent or refund of security deposit.

3) SUBLETTING/SUBLEASING/HOME-SHARING/ASSIGNMENT --->> Only persons designated in the rental lease by the Landlord or agreed to in writing by Landlord shall reside in the rented premises. Occupants/Tenants shall not sublet, sublease or home-share said premises, or any part thereof, or assign the lease in whole or in part without the prior written consent of the Landlord. *

I/We Understand and Agree that if I/we violate this Subletting Article that it is grounds for Eviction with no proration of rent or refund of security deposit.

4) RIGHT TO ACCESS --->> Occupants/Tenants shall not unreasonably withhold consent to the Landlord to enter into the home in order to inspect the premises; make necessary or agreed repairs or improvements, or exhibit the dwelling to prospective or actual purchasers, mortgagees, tenants, workmen, or contractors. The Landlord or Landlord's agent(s) may enter the dwelling without consent of the Occupants/Tentants in case of emergency. The Landlord shall not abuse the right of access and unless it is impracticable to do so, Landlord shall give at least 24 Hrs notice of intent to enter and may enter only at reasonable times of day. *

I/We Understand and Agree to the Landlords Right To Access and will not impede this Right in order for the Landlord to conduct business as stated above.

5) POOLS --->> NO above ground pool, spa, sauna, hot tub, etc - of any shape, size or model/style is to be placed at any location on the property. *

I/We Understand and Agree that if I/we violate this Pools Article that it is grounds for Eviction with no proration of rent or refund of security deposit.

6) RENTERS INSURANCE --->> Occupant/Tenant shall be responsible for insuring Occupant's/Tenant's own possessions against fire, water and other catastrophes *

I/We Understand and Agree that the Landlord recommends I/we acquire Renters Insurance and I/we will not hold Landlord or Landlord's agents liable in the event we fail to do so.

======== PRIOR DWELLINGS

Have you, your spouse, significant other or a member of your family or household, ever lived in a dwelling that had bedbugs? *

Have you, your spouse, significant other or a member of your family or household, ever been evicted or asked to leave a residence or rental property? *

Have you, your spouse, significant other or a member of your family or household, ever willfully refused to make a mortgage payment or pay rent when it was due, or left owing a balance? *

======== LEGAL QUESTIONS

Have you, your spouse, significant other or a member of your family or household, every been adjudicated a sex offender? *

Have you, your spouse, significant other or a member of your family or household ever been charged with a crime (other than a traffic violation)? *

Are you, your spouse, significant other or a member of your family or household subject to tax liens, garnishments, withholding orders, or any other type of court-ordered collection activity. *

CLAUSE A ---->> I/We, the undersigned, understand that Power Real Estate is the Leasing Agent and representative for the Owner/Landlord and that the Leasing Agent's fees will be paid by the Owner/Landlord. The undersigned acknowledge(s) that this written notice was received prior to the undersigned receiving a lease agreement. *

I/We have read Clause A - I/We Understand and Agree

CLAUSE B ---->> I/We, the undersigned, declare the foregoing information is complete and accurate to the best of my/our knowledge. I/We hereby authorize you or your representing agents, to use all of this above information to approve or disapprove this application, including the right to make independent investigations of current or past employment history, credit references, public records and to run my/our credit. I/We, the undersigned, understand that giving false information is a serious criminal offense and that a misrepresentation on this document can result in legal action against you and/or "eviction" at any time. *

I/We have read Clause B - I/We Understand and Agree

CLAUSE C ---->> I/We, the undersigned, understand that failure to Rent the home after the application has been approved will result in the Security Deposit being retained as liquidated damages. All Security Deposits placed on the Rental House after the application is approved are Non-Refundable as well. *

I/We have read Clause C - I/We Understand and Agree

CLAUSE D ---->> I/We, the undersigned, understand that ---- if this home is on City Sewage, the following information will not apply to me ---- but if the home is on a Septic System, the following information does apply to me. ---- This is a Single Family Residence, which means the Board of Health has approved the septic system for the specific number of bedrooms in the home. Having more than 5 people living in the home (whether short-term or long-term) can overload the system and cause damages. I understand that I will be responsible for the cost of repairs should this occur; as well as any other necessary repairs that may be required due to negligence or misuse. *

I/We have read Clause D - I/We Understand and Agree

CLAUSE E ---->> I/We, the undersigned, understand that I/we MUST give 30 DAYS WRITTEN NOTICE prior to vacating the Rental House. Failure to do so could result in your Security Deposit being retained as liquidated damages. *

I/We have read Clause E - I/We Understand and Agree

CLAUSE F ---->> I/We, the undersigned, understand that a full or partial Security Deposit Refund will be determined by several factors, such as, but not limited to, rent being current or delinquent, damages to the property, basic cleanliness of the property when relinquishing it. I/We, the undersigned, understand that I/we will need to schedule a walk through of the property with the owner, at the time of relinquishment to determine how much, if any, of the Security Deposit will be Refunded. *

I/We have read Clause F - I/We Understand and Agree

APPLICANT # 1 - Signature *

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Main Content

SERVICE ANIMAL & ESA – REQUIREMENTS

======== BANKING INFORMATION

======== YOUR CURRENT LIVING SITUATION

======== MINOR AGE OCCUPANTS - Children

======== PETS / ANIMALS

======== SERVICE ANIMAL OR ESA ANIMAL

======== VEHICLE INFORMATION

======== BANKRUPTCY INFORMATION

======== RENTAL HOUSE ARTICLES

======== PRIOR DWELLINGS

======== LEGAL QUESTIONS

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