Applicant Information

Full Name *

Phone Number *

Date of Birth *

SSN *

Driver's License State and # *

Upload a photo of your Driver's License *

Email Address *

Current Address *

Are you a student? *
—Please choose an option—YesNo

Degree (if applicable)

Are you married? *
—Please choose an option—YesNo

If you have children, enter their ages

Property Type
—Please choose an option—ApartmentDuplexSingle-Family HomeTrailerTriplex

# of Bedrooms
—Please choose an option—1234+

Preferred Move-In Date *

Enter names of roommates, if applicable

Do you have any pets? *
—Please choose an option—YesNo

Describe your pets, if applicable

Previous Rental Information

Name of current or previous landlord*

Contact Number *

Current or previous rental address*

Move-In Date *

Move-Out Date *

Did you fulfill your lease? *
—Please choose an option—YesNo

Reason for leaving *

Employment Information

Current Employer *

Position *

Manager's Name *

Manager's Contact Number *

Start Date *

Annual Income *

By typing your name here, you agree that this constitutes as your legal signature and agree to the terms below. *


Terms:
I authorize and give permission to Ellis Rentals LLC to verify all information provided on this form as to my credit, employment, criminal background check, personal references, and current and previous rental history.