11/07/2025
GERTZ PROPERTIES LLC RENTAL APPLICATION
Applicant (Photo ID must be provided.)
Full name ___________________________
Phone: __________________
Email address: _______________________
Social Security Number ________________
Date of birth: ________________________
Additional Occupants (List everyone, including children. Give full name and relationship to you.)
1.
2.
Rental History
1. Current address _______________________________________________
Dates lived at this address _________________________
Reason for leaving _____________________________________________
Amount paid for rent or mortgage ________________
LANDLORD’S NAME AND PHONE _____________________________
1. Previous address _______________________________________________
Dates lived at this address _________________________
Reason for leaving _____________________________________________
Amount paid for rent or mortgage _________________
LANDLORD’S NAME AND PHONE _____________________________
Employment History
1. Name and address of current employer _____________________________
________________________________________________________
Phone ______________________
Date employed at this job ___________________
2. Name and address of previous employer ___________________________
_________________________________________________________
Phone ______________________
Dates employed at this job _____________________
Income (Proof of income for one month must be submitted with application.)
1. Gross monthly income _______________
2. Monthly amounts of other income ______________
Credit Accounts and Loans
1. Type of credit card ____________ monthly payment: ___________
2. Type of loan _________________ monthly payment: ___________
3. Other major obligation _________ monthly payment: __________
Personal Information
Do you smoke? yes ______ no _______(No smoking permitted in apartment.)
Have you ever: EXPLAIN ANY YES.
filed for bankruptcy? yes _______ no _________
been sued? yes ________ no ________
been evicted? yes _________ no ________
been arrested? yes _______ no ________
Do you own pets? ____(Pets are $300 fee and additional $50/month rent.)
How long do you plan to live here?
How did you hear about us?
References and Emergency Contact.
1. Name and address_________________________________________________
____________________________________________________________
Phone _____________________
Relationship to you __________________________
2. Name and address _________________________________________________
____________________________________________________________
Phone _____________________
Relationship to you __________________________
I certify that all the information given above is true and correct and understand that my application will be denied or my lease may be terminated if I have made any false or incomplete statements in this application. I authorize verification of the information provided in this application from my current and previous landlords, employers and personal references.
Date ___________________ Signature ________________________________
APPLICATION FEE OF $35 MUST BE SUMITTED WITH APPLICATION. This fee is nonrefundable. A $200 good faith fee must be paid with application and will be applied to security deposit. SD will be refunded if application is denied. Applicant loses fee if applicant does not take possession of apartment 3 days from submission of application. Photo ID must be submitted.
PREVIOUS LANDLORD REPORT
Applicant Name:
Address:
Signature: Date:__________________________________________
Landlord name:
Landlord address:
Landlord phone number: Landlord fax number:
Landlord email address:____________________________________________________
LANDLORD MUST COMPLETE THE FOLLOWING SECTION:
The person above has applied for residency at one of our apartments and has indicated that you are currently or previously were their landlord. We would appreciate your cooperation in completing this form.
1. How long did applicant live at this address? ___________________
2. What was the monthly rent? ________ Were utilities included? ______________
3. Was applicant ever late paying rent? ____________ How many times? _______
4. Was the applicant destructive to the apartment or surrounding area? ___________
5. Did the applicant keep the apartment clean? ___________________
6. Would you rent to this applicant again? __________ If no, why? ________________
7. Did applicant fulfill their lease? __________________________________________
8. Has applicant given proper notice of vacancy? ______________________________
9. Did applicant follow the terms of the lease?___________________________________
________________________________________________________________________
10. Additional comments:___________________________________________________
Name/title: Date:
Development/property name:
Thank you for completing this form. Please return to Gertz Properties LLC by email at [email protected].
