New York Rental Application Template
This Rental Application is designed to comply with the guidelines set forth by New York State laws. It is intended for use in evaluating potential tenants for residential lease agreements within New York. The applicant agrees that the information provided is accurate and consents to the verification of references and details given.
Applicant Information
- Full Name: ___________________________________________
- Date of Birth: ___________________________________________
- Phone Number: ___________________________________________
- Email Address: ___________________________________________
- Current Address: ___________________________________________
- Social Security Number (optional): ___________________________________________
- Driver’s License or State ID Number: ___________________________________________
Employment Information
- Current Employer: ___________________________________________
- Employer Address: ___________________________________________
- Position/Title: ___________________________________________
- Supervisor Name: ___________________________________________
- Employment Duration: ___________________________________________
- Monthly Income: $___________________________________________
- Additional Income (specify source): $___________________________________________
Residential History
- Previous Address: ___________________________________________
- Landlord Name: ___________________________________________
- Landlord Contact Information: ___________________________________________
- Duration of Residency: ___________________________________________
- Reason for Leaving: ___________________________________________
References
- Name: ___________________________________________
- Relationship: ___________________________________________
- Contact Information: ___________________________________________
Additional Information
- Have you ever been evicted from a rental residence?
___ Yes ___ No
- If yes, explain: ___________________________________________
- Have you ever been convicted of a crime?
___ Yes ___ No
- If yes, explain: ___________________________________________
By signing below, I hereby authorize the verification of the information provided on this form as to my credit and employment. I understand that false or incomplete information may result in the rejection of this application.
Signature: ___________________________________________
Date: ___________________________________________