Nebraska Rental Application Template
This Rental Application is designed to gather information from a potential tenant. It is compliant with the laws specific to the state of Nebraska. By completing this application, the applicant provides consent for a background and credit check as required under Nebraska law..
Applicant Information
- Full Name: _________________
- Date of Birth: _________________
- Social Security Number: _________________
- Phone Number: _________________
- Email Address: _________________
- Current Address: _________________
- City: _________________
- State: _________________
- Zip Code: _________________
- Current Landlord's Name: _________________
- Current Landlord's Phone Number: _________________
Employment Information
- Employer Name: _________________
- Employer Address: _________________
- City: _________________
- State: _________________
- Zip Code: _________________
- Job Title: _________________
- Supervisor's Name: _________________
- Supervisor's Phone Number: _________________
- Annual Income: _________________
Rental History
- Previous Address: _________________
- City: _________________
- State: _________________
- Zip Code: _________________
- Previous Landlord's Name: _________________
- Previous Landlord's Phone Number: _________________
- Reason for Leaving: _________________
References
- Reference #1 Name: _________________
- Relationship: _________________
- Phone Number: _________________
- Reference #2 Name: _________________
- Relationship: _________________
Phone Number: _________________
Additional Information
- Have you ever been evicted?: _________________ (Yes/No)
- If yes, explain: _________________
- Do you have pets?: _________________ (Yes/No)
- If yes, describe: _________________
By signing below, the applicant affirms that all information provided in this application is true and correct to the best of their knowledge. The applicant understands that any false information may result in the rejection of this application.
Applicant's Signature: _________________ Date: _________________