Rental Application Form

Rental Application

Step 1 of 3 - Initial Information

Please fill out only one application per applicant. If you are applying with a roommate or spouse please have them submit a separate application. Only Fully Completed Applications Will Be Reviewed.
Property Address Applying For:*
Desired Move In Date:
MM slash DD slash YYYY
Contact Information
Name*
First Last
Email*
Enter Email Confirm Email
Phone*
Other Phone
Current Address
Note: Please provide at least 3 years of residential history.
Address*
Street Address City State ZIP Code
Resided From:
MM slash DD slash YYYY
To:
MM slash DD slash YYYY
Manager/Owner Name:
Phone
Reason For Leaving
Previous Addresses
Address
Street Address City State ZIP Code
Resided From:
MM slash DD slash YYYY
To:
MM slash DD slash YYYY
Manager/Owner Name:
Phone
Reason For Leaving
Address
Street Address City State ZIP Code
Resided From:
MM slash DD slash YYYY
To:
MM slash DD slash YYYY
Manager/Owner Name:
Phone
Reason For Leaving
Personal Information
Date Of Birth*
MM slash DD slash YYYY
SSN*
Drivers License Number
License State
Financial Information
Bank Name
Account Number
Account Type
Checking, Savings, Other
Protecting your privacy is important to us. Your email address and personal information are confidential and will not be sold or rented. See our Privacy Policy for more details.

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Terms of Agreement
By checking the box and electronically signing your full name below, you declare that all your statements in this application are true and complete. By submitting this electronic application, you are directing and authorizing Kali Real Estate, Inc to verify this information and obtain additional background information about you through any means, including using a third party consumer agency such as Rentec Direct LLC, 301 NE 6th St, Grants Pass, OR 97526, 800.881.5139, personal and professional references, employers and other rental housing owners. If you fail to answer any question or give false information, the property may reject your application, retain all application fees and deposits as liquidated damages for its time and expense, and terminate your right of occupancy. You further direct and authorize Kali Real Estate, Inc to obtain from any law enforcement agency, present or past employer or supervisor, landlord, finance bureau/office, credit bureau, collection agency, college, university or other institute of learning or certification, private business, military branch or the national personnel records center, personal reference and/or other persons, and authorize the same to give records or information that they may have concerning your criminal history, motor vehicle/driving history, earnings history, credit history, character, general reputation, personal characteristics, mode of living, employment records, record of attendance and earned degrees or certificates, or any other information requested, whether the said records are private or public, and including those which may be deemed to be privileged or confidential in nature and you irrevocably and unconditionally release all such persons, including any named or unnamed informant, from any liability resulting from the furnishing of this information. You have the right, upon written request made within a reasonable time after receipt of this notice to request disclosure of the nature and scope of any investigative consumer report. Please be advised that the nature and scope of the most common form of investigative consumer report obtained with regard to tenants is an investigation into your prior rental history, education, and employment. You also acknowledge that our privacy policy is available to you. I understand that if I want a paper copy of this Authorization Form, I may print it out or I may request a copy by contacting Kali Real Estate, Inc. I understand that typing my name in the 'Authorized/Acknowledged by' section below, checking the box next to the words “I have received..”, and clicking on the Submit Application button below, constitutes my electronic signature, dated as of when I click on the button, and that by doing so: • I am authorizing Rentec Direct LLC to conduct the background check(s) described above. • I am consenting to use electronic means to (i) sign this form, and (ii) receive the Disclosure Statement appearing above.
*
- I have received and read a copy of the Terms of the Application Agreement & Summary of Your Rights Under The Fair Credit Reporting Act.
Terms of the Application Agreement & Summary of Your Rights Under The Fair Credit Reporting Act.
Authorized/Acknowledged by (Type your Full Name below):*
First Last

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Rental Application

Step 1 of 3 - Initial Information

Please fill out only one application per applicant. If you are applying with a roommate or spouse please have them submit a separate application. Only Fully Completed Applications Will Be Reviewed.

Contact Information

Current Address

Previous Addresses

Personal Information

Financial Information

Employment Details

Emergency Contact

Dependents

Pets

Upload One Full Month Proof of Income:

Does everything look correct?

Terms of Agreement