New York Rental Application Template
This New York Rental Application is intended to be used by landlords to collect basic personal information from potential tenants. It complies with the New York State Tenant Protection Act of 2019. Please complete all sections of the application truthfully and to the best of your ability.
Applicant Information
Full Name: ___________________________
Date of Birth: ________________________
Current Address: ______________________
City: _______________ State: NY Zip Code: _________
Phone Number: ________________________
Email Address: ________________________
Rental History
Current Landlord's Name: ________________
Current Landlord's Contact Information: ________________
Previous Address: ______________________
City: _______________ State: __________ Zip Code: _________
Previous Landlord's Name: _______________
Previous Landlord's Contact Information: _______________
Employment Information
Employer: _____________________________
Employer Address: _____________________
City: _______________ State: __________ Zip Code: _________
Position: _____________________________
Annual Income: ________________________
Contact Information for Human Resources or Supervisor: _______________
References
Please provide contact information for at least two personal references.
- Reference Name: _______________ Contact Information: _______________
- Reference Name: _______________ Contact Information: _______________
Additional Information
Do you have pets? Yes [ ] No [ ] If yes, please describe: _______________
Have you ever been evicted from a rental property? Yes [ ] No [ ]
If yes, please provide details: ________________________________
Will you require a parking space? Yes [ ] No [ ]
Authorization
By signing below, I hereby authorize the landlord or the landlord’s agent to conduct a background check, including but not limited to a credit check, criminal history, past rent history, employment verification, and I authorize all past landlords, employers, and personal references named in this application to release information about me. I understand that this application does not guarantee the renting of a premise.
Applicant Signature: ___________________ Date: _______________
This Application is subject to the laws and regulations of the state of New York. The information provided will be used solely for the purpose of screening potential tenants and will be kept confidential. Submission of this application does not guarantee tenancy.