North Carolina Rental Application
This Rental Application is designed to comply with applicable North Carolina state laws and regulations. It is intended to gather necessary information from prospective tenants. By completing this application, the applicant agrees to a background and credit check as permitted under North Carolina law.
Please complete all sections of this application. Incomplete applications may not be considered.
Applicant Information
    Full Name: ___________________________________________________
    Date of Birth: ________________________
    Social Security Number: _______________________________________
    Phone Number: _________________________
    Email Address: _______________________________________________
    Current Address: ______________________________________________
    City: ______________________ State: ____ Zip Code: _____________
    How long at current address: ___________________________________
    Reason for moving: ____________________________________________
Employment Information
    Current Employer: _____________________________________________
    Employer Address: _____________________________________________
    City: ______________________ State: ____ Zip Code: _____________
    Job Title: _______________________
    Supervisor Name: _____________________________________________
    Phone Number: _________________________
    Monthly Income: $_____________________________________________
    How long with this employer: ___________________________________
Additional Occupants
List all additional occupants who will reside in the unit. Include all children and adults.
- Name: ___________________________________ Age: ______ Relationship: _______________
- Name: ___________________________________ Age: ______ Relationship: _______________
- Name: ___________________________________ Age: ______ Relationship: _______________
Rental History
Please list your rental history for the past 3 years.
- 
        Address: ___________________________________________________
 Landlord/Management Company: ______________________________
 Phone Number: _______________________
 Monthly Rent: $__________________
 Dates of Residency: From ____________ To ________________
- 
        Address: ___________________________________________________
 Landlord/Management Company: ______________________________
 Phone Number: _______________________
 Monthly Rent: $__________________
 Dates of Residency: From ____________ To ________________
References
Provide at least two references who are not relatives.
- 
        Name: ______________________________________________________
 Relationship: _______________________
 Phone Number: _______________________
- 
        Name: ______________________________________________________
 Relationship: _______________________
 Phone Number: _______________________
Authorization
By signing below, I authorize the verification of the information provided on this form as to my credit and employment. I understand that this is a preliminary application and does not guarantee lease or rental of property. I hereby declare that the information provided in this application is true and correct to the best of my knowledge.
    Applicant Signature: ___________________________________________
    Date: ___________________________