North Carolina Rental Application Form
NORTH CAROLINA RENTAL APPLICATION
Application*Fee*$____*per *married*couple /$____*per*adult*roommate.**Please*fill*all*blanks;*unanswered*blanks*may*
result*in*application*being*denied.**The*attached *Rental*Verification*and*Employ ment*Verification*are*to*be*signed*by*the*
applicant*so*that*we*may*contact*t he*applicant's*cur rent*landlord*and*employer*to*verify*rental*and*employ ment*status.*
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The*undersigned*hereby*makes*the*applicatio n *to*rent*the*property*located*at:** *
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at*a*monthly*rental*amou nt*of*$** * Mo ve*in*date*requested:*** *
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Who*Showed*you*the*house:*** *
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Contact/Identifying/Information*
Full*Nam e:********************************************************** **Date*of*Birth:************************************** **S.S.*Number:***********************************************
Home*Phone:*******************************************************Cell:*******************************************************Work: **********************************************************
EOMail:****************************************************************************** * Drive*License*#*and*State:****************************************************************************
Spouse*Name:******************************************************** *Date*of*Birth:************************************** **S.S.*Number:*******************************************
Home*Phone:*******************************************************Cell:*******************************************************Work: **********************************************************
EOMail:*** Drive*License*#*and*State:*** * *
Vehicle*(make/model):*** * *Year:*** Tag#:*** State:*** * *
2nd*Vehicle:**************************************************************************Year:***************************Tag#:***********************************************State:**************
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Other*Vehicles*(Boats,*etc):*
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Do*you*or*any*member*of*your*applicant*hou sehold *smoke?*Yes*******No*******O*Name(s):*** *
Do*you*or*any*member*of*your*applicant*hou sehold *have*or *plan*to*acquire*a *gun*or*other*licensed *or*restricted*weapon?*
Yes*******No*******Name(s):*** * *
Do*you*or*any*member*of*your*applicant*hou sehold *now*h ave* or*have*you*ever*had*a*substance*abuse*problem*including*
abuse*of*Alcohol,*use*of*illegal*drugs,*etc.?**Yes*******No*******Name(s):*** *
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Residence/History*
(For/past/3/years,/beginning/with/most/current)*
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Current*Hom e*Address:*** * * * * Own?*Yes*******No*******Mort gage*$*** * *
Cit y:*** * *State:*** Zip:*** Length*of*stay*at*this*address:*** *
Rental?*Yes*******No*******Rent*$:*** * *Landlord*Em ail:*** * * *Landlord*Phone:*** *
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