FREE Rent-To-Own Application

This is NOT an application for a loan.  The following is a basic personal and financial profile. Completing this application in no way obligates you to use our services and there is no charge for this application.  You can submit your application online by:

  • completing the fields in the below form (by typing your information below and clicking “Submit Application”, you are attesting to the fact that you are the person named in the application and the data contained in the fields below  is true and accurate to the best of your knowledge); OR
  • PRINT THIS PAGE (press “Ctrl+P”), complete the information manually, then scan/email to or fax to 443-737-4449.

Rent-To-Own Application

Fields notated with * are required


Which Rent-To-Own home(s) are you interested in?

First Name* Middle Name*

Last Name* Maiden/Former Name* [?]

Cell Phone* Day Phone* Nite Phone*

(format: 410-555-1234)

Email Address*


Driver's License #* State Issued*

Date of Birth* (format: 12/21/12)

Desired Move-In Date or Time Frame* [?]

What is the Maximum OPTION DOWN PAYMENT/Option Fee you can raise prior to move in?* [?]

What is the Highest MONTHLY Payment you are comfortable paying?*

Home Requirements [?]

How would you describe your credit?*

Are you willing to enroll in credit repair if the results were guaranteed or your money back?* [?]

How did you hear about us?*


Current Home Address * (Street Address, City, State, Zip Code)

How long have you been at this address?* Current monthly payment*

Name* Phone*

Ok to call Landlord to verify Rental History?*

Why are you moving from your current home?*

# of Adults over 18 in Household* # of Children under 18 in Household*

List full names & ages of all children

# of Pets*

Description of Any Pets ("Name," Type, Breed, Age & Weight) [?]

Prior Rental Address (Street Address, City, State, Zip Code) [?]

Prior monthly rent

Prior landlord:
Name Phone #


Current Employer's:
Name* Address*

Current Position/Job Title*

Gross Monthly Salary (US dollars)*

How long at present job?*

How long in present line of work/industry?*

Employer Contact # to Verify Employment*

Other Monthly Income (US dollars) [?]

Describe Source of Additional Income


Have you ever been summoned to court for failure to pay rent?*

Have you ever been evicted?*

Have you ever been in foreclosure?*

Have you ever had your wages garnished?*

Have you ever declared bankruptcy?*

Have you ever been convicted of a sex crime?*

***If Yes to any of the above, please list dates, details* [?]


Total credit card(s) balance Total Credit Card Monthly Payment(s)

Car loan balance #1 Car loan monthly payment #1

Car loan balance #2 Car loan monthly payment #2

Total mortgage(s) balance Mortgage monthly payment(s)

Total student loan balance Student Loan monthly payments [?]

Describe any child support payments you have to pay* [?]

Do you owe anyone money? (Besides lending institutions)*

If Yes, please explain

Personal reference #1
Name* Relation* Phone #*

List any other personal references you would like to provide

Additional Comments and/or Questions

DIGITAL SIGNATURE - By typing your name you are attesting to the fact that you are the person named in the application data contained in the fields below and that the information you have submitted is true and accurate to the best of your knowledge.

Digital Signature*


Verify That You're a Real Person!


Please type the letters above:

By clicking “Submit Application”, you hereby authorize and/or its partners to conduct:

1.  Employment verification, 2.  Rental History verification, 3.  Credit check and evaluation, 4.  Criminal Background check, 5.  Verify personal references

All information on this application is held STRICTLY CONFIDENTIAL and will NOT be shared outside of and/or their Agents (which may include third party services to complete the above stated verifications), the Rent-To-Own Property Owner to which the applicant seeks approval, and those listed on this document as references or verification contacts. This does not apply to any information submitted that is found to be false, purposefully incorrect, fraudulent, dishonest or misleading.  

If your application is selected and PRE-approved by Property Owner, applicant(s) is required to deposit the below stated minimum funds into escrow to cover background check(s), rental history verification(s), and any other final checks & verifications deemed necessary or recommended: