Application Form

Rental Application

1Before You Begin

2Applicant Screening Charge Receipt

3Personal Information

4Employment / Income

5Personal References

6Personal Property

7Final page

Before you begin:

Applications are processed on a first come, first serve basis. Each resident 18 years or older must submit a separate rental application. It is your responsibility to call our office during business hours once your application has been submitted to verify receipt of all necessary documents and screening fees to be placed in line for the property. If you do not contact us to verify we have received your information your application will be considered incomplete and will not be processed. Applications are only complete if each adult 18 years or older has fully filled out the application and if a valid form of photo identification, proof of income, and a photo of your pet or animal are attached. You may submit applications through this website, email, fax, or delivered to our drop box located outside our office front door. The application screening fee must be paid in full. Application screening fees are non-refundable once the application has been processed and are applied only toward one property at a time. You may submit the applicant screening fee by check at our office or by the “Pay Online” link on our website. If your application is not first in line, your application will be held in line in order as received and the application fee will not be processed unless your application becomes first in line for the property you are applying for.

To complete this rental application, you must be prepared to provide 2 years of residential history as well as contact information for your rental references. You will also be asked to provide information on your monthly income. Please note that all properties require that applicants combined net income is at least three (3) times the monthly rent amount. It is the responsibility of the applicant to confirm that the application has been received, that the applicable fee has been paid, and to confirm that the applicant has been placed in line on the requested property.
I have read and understand these statements*
- Yes

If you would rather print and fill out the form offline download the PDF version here. Download Application (PDF)
Name*
First Last
Rental Street Address
Hidden
Property URL applied from (if any)
Fee Amount: $60.00

"Applicant Screening Charge" means any non-refundable payment of money charged by a landlord of a prospective tenant or applicant prior to entering into a rental agreement with that applicant for a residential dwelling unit, the purpose of which payment is to process an application for a rental agreement for a residential dwelling unit.
- I understand that renter's insurance is a requirement of our tenancy, if our application is approved. (Exceptions may apply, see Oregon Senate Bill 91 Section 2.8} The required amount of insurance is $100,000.
- I will bring proof of insurance to the signing appointment.
- I understand that a deposit is required to guarantee and hold the unit. If for any reason I fail to rent the unit, this deposit is non-refundable.
Fee Disclosure:

Amounts listed below are subject to change before the rental agreement is executed.
Landlord may charge the following non-compliance fees:
- Late charge of $100 per occurrence
- Smoke alarm & carbon monoxide alarm tampering fee of $250 per occurrence
- Dishonored check fee of $35 per occurrence plus amount charged by bank
- Early lease termination fee equal to 1 ½ times the rent amount
Owner/Agent may charge the following non-compliance fees after giving a written warning notice of initial violation if noncompliance occurs within one year, $50 for 2nd violation and $50 plus 5% of current rent for subsequent violations.
- Late payment of a utility fee of $50 per occurrence
- Failure to clean up animal waste, garbage, rubbish or other waste fee of $50 per occurrence
- Parking violation or other improper use of a vehicle fee of $50 per occurrence
- Smoking in a clearly designated non-smoking unit or area of the premises fee of $50
- Unauthorized animal capable of causing damage to persons or property fee of $50
I have read, understood and had any questions answered regarding the above information.*
- I agree

Personal References
Relative Name*
Phone*
Relationship*
Relative's Address*
Street Address City State ZIP Code
Emergency Contact
Emergency Contact Name*
Phone*
Relationship*
Emergency Contact's Address
Street Address City State ZIP Code
Personal Reference
Reference Name*
Phone*
Relationship*

Applicant's Comments & Explanations
Comments or Explanations
Members of Household
For purposes of identification only, please list names and either ages or dates of birth of other persons to occupy the unit:
Household Member*
Name Age or Date of Birth
Applicant Screening Charge Disclosure
1. Owner/Agent may obtain a tenant screening report which generally consists of:
  1. Credit history including credit standing;
  2. Public records, including but not limited to judgments, liens, evictions and status of collection accounts;
  3. Information verification;
  4. Current obligations and credit ratings;
  5. Criminal records.
2. Owner/Agent is requiring payment of an Applicant Screening charge of $60.00 none of which is refundable unless the Owner/Agent does not screen the applicant. Application is valid for 60 days from the date of receipt by Owner/Agent
3. Any charges imposed upon the Owner/Agent by a Homeowner’s or Condominium Association for anyone who moves into or out of a unit with the association, may be passed through to the Tenant(s) for payment as allowed by law.
4. If the mail receptacle associated with the dwelling unit is a locking type, Tenant(s) are solely responsible for the fees charged by the Postmaster for the re-keying of the box should a key not be provided by the Owner/Agent, or if the mail box has not been re-keyed between tenancies.
Do you agree to the above?*
- I agree to the applicant screening charge disclosure
Name*
By entering your name and the date, you agree that this Application is an electronic record executed by you using your electronic signature, and you acknowledge and agree to all of the terms.
First Last
Date*
Today's date.
MM slash DD slash YYYY
Phone
This field is for validation purposes and should be left unchanged.

Make	Model	Year	License #	ST

Make	Model	Year	License #	ST

Type/Breed	Age	Weight	Spayed/Neutered?

Rental Application

Before you begin:

Personal Information

Address 1

Address 2

Address 3

Answer the following questions:

Current Employer

Previous Employer

Other Income

Personal References

Emergency Contact

Personal Reference

Personal Property

Animals

Applicant's Comments & Explanations

Members of Household

Applicant Screening Charge Disclosure

Name	Age or Date of Birth