CALI FORNIA APPLICATION TO RENT/SCREENING …-~ cali fornia., association ~r of realtors® application to rent/screening fee (car. form lra,revised 11/12) i. application to rent this
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~-~ CALI FORNIA., ASSOCIATION~r OF REALTORS®
APPLICATION TO RENT/SCREENING FEE(CAR. Form LRA, Revised 11/12)
I. APPLICATION TO RENTTHIS SECTION TO BE COMPLETED BY APPLICANT. A SEPARATE APPLICATION TO RENT IS REQUIRED FOR EACHOCCUPANT 18 YEARS OF AGE OR OVER, OR AN EMANCIPATED MINOR.
1. Applicant is completing Application as a (check one) 0 tenant, 0 tenant with co-tenant(s) or 0 guarantor/co-signor.Total number of applicants _
3. PERSONAL INFORMATIONA. FULL NAME OF APPLICANT _B. Date of Birth (For purpose of obtaining credit reports. Age discrimination is prohibited by law.)C. Social security No. Driver's license No. _
State Expires _D. Phone number: Home Work Other _E. Email _
F. Name(s) of all other proposed occupant(s) and relationship to applicant _
G. Pet(s) or service animals (number and type) _H. Auto: Make Model Year __ License No. State __ Color _
Other vehicle(s): _
I. In case of emergency, person to notify _Relationship _
Address Phone _
J. Does applicant or any proposed occupant plan to use liquid-filled furniture? 0 No 0 Yes Type _K. Has applicant been a party to an unlawful detainer action or filed bankruptcy within the last seven years? 0 No 0 Yes
If yes, explain _
L. Has applicant or any proposed occupant ever been convicted of or pleaded no contest to a felony? 0 No 0 YesIf yes, explain _
.M. Has applicant or any proposed occupant ever been asked to move out of a residence? 0 No 0 YesIf yes, explain _
4. RESIDENCE HISTORYCurrent address Previous address _City/State/Zip City/StatelZip _From to From to _Name of LandlordlManager Name of Landlord/ManagerLandlord/Manager's phone Landlord/Manager's phone --------------Do you own this property? 0 No 0 Yes Did you own this property? 0 No 0 YesReason for leaving current address Reason for leaving this address _
5. EMPLOYMENT AND INCOME HISTORYCurrent employer _Current employer address _From To _Supervisor -:- _Supervisor phone _Employment gross income $ per _Other income info _
Previous employer _Prevoemployer address _From To _Supervisor _Supervisor phone -:- _Employment gross income $ per _Other income info _
Applicant understands and agrees that: (i) this is an application to rent only and does not guarantee that applicant will be offered thePremises; (ii) Landlord or Manager or Agent may accept more than one application for the Premises and, using their sole discretion,will select the best qualified applicant, and (iii) Applicant will provide a copy of applicant's driver's license upon request.
Applicant represents the above information to be true and complete, and hereby authorizes Landlord or Manager or Agent to: (i) verifythe information provided; and (ii) obtain credit report on applicant.
If application is not fully completed, or received without the screening fee: (i) the application will not be processed, and (ii) theapplication and any screening fee will be returned.Applicant Date Time _
Return your completed application and any applicable fee not already paid to: _Address City State __ Zip _
II. SCREENING FEETHis SECTION TO BE COMPLETED BY LANDLORD, MANAGER OR AGENT.Applicant has paid a nonrefundable screening fee of $ , applied as follows: (The screening feemay not exceed $30.00, adjusted annually from 1-1-98 commensurate with the increase in the Consumer Price Index. A CPI inflationcalculator is available on the Bureau of Labor Statistics website, www.bls.gov. The California Department of Consumer Affairscalculates the applicable screening fee amount to be $42.06 as of 2009.)$ for credit reports prepared by _
$ for (other out-of-pocket expenses); and
$ for processing.The undersigned has read the foregoing and acknowledges receipt of a copy.
Applicant Signature Date
The undersigned has received the screening fee indicated above.