Rental Application - HUD

Phone Number

Full Legal Name

Date of Birth

Month

Day

Year

Current Employer (if not currently employed, please list N/A)

How long have you been at your current job?

List your last 3 landlords and their contact information

Upload a copy of your driver's license. Please include driver's licenses for all individuals over the age of 18

Social Security Number

Does your voucher cover ALL of the rent? If not, how much does it cover?

Attach your last 2 paystubs. Please include paystubs for all individuals over the age of 18 - if voucher covers ALL rent, proof of income is not required

List additional household members along with their date of birth

If you have no additional members, leave the box blank.

If additional members are over 18 years old, please provide their social security number.

Have you been evicted before?

Yes

Do you have a criminal record? If not leave blank.

Explain the charges and dates of the charges

What is your current address?

Description of Vehicle

Year, make, model, color, etc.

Preferred Payment Schedule

Weekly

Bi-Weekly

Monthly