Rentals
Sales

Kauai Long-Term Rentals

Kauai Property Sales

Online Lease Application

This form is for your convenience. The online application is a shortened version of the final application. If you are approved for occupancy, you may be required to complete the full application. If you are uncomfortable sending this information online, simply contact us and we can either fax or mail you an application, or download a printable application. After you've printed and filled it out fax or mail it to us.

	RENTAL APPLICATION For Property Located at:	NOTICE TO APPLICANTS: This application will be submitted to TBL RentCheck for verification. Please furnish all information requested and have all applicants sign at the bottom of the page. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED.
How did you hear about this rental?: Online Newspaper Craigslist For Rent Sign Other Referred by:

Applicant Information

Applicant’s Last Name:

First Name:

Initial:

Telephone:

Email Address:

Co-Applicant’s Last Name:

First Name:

Initial:

Telephone:

Email Address:

Mailing Address:

Number of proposed occupants, including applicants:

Names of other occupants:

Pets:

Yes

If yes, list kind & number:

Do you smoke?:

Yes

Are you or any household member subject to a lifetime registration as a sex offender?:

Yes

If yes, list name:

Have you ever:	Filed for bankruptcy?: Yes No	Been Sued?: Yes No	Been evicted?: Yes No
	Been convicted of a crime?: Yes No	Explain any "yes" in a field below

Housing Data
Current Address:	From:	Landlord’s Name:	Telephone:	Rent Amount: $
Reason for moving:
Previous Address:	From - To:	Landlord’s Name:	Telephone:	Rent Amount: $
Reason for moving:

Income & Employment data
Current Employer:	Position:	How Long:	Monthly Salary: $	Supervisor:	Telephone:
Previous Employer:	Position:	How Long:	Monthly Salary: $	Supervisor:	Telephone:
Co-Applicant’s Current Employer:	Position:	How Long:	Monthly Salary: $	Supervisor:	Telephone:
Co-Applicant’s Previous Employer:	Position:	How Long:	Monthly Salary: $	Supervisor:	Telephone:

Income & Financial Information
Credit Card:	Monthly Payment: $	Balance Owed: $	Credit Card:	Monthly Payment: $	Balance Owed: $
Type of Loan:	Monthly Payment: $	Balance Owed: $	Type of Loan:	Monthly Payment: $	Balance Owed: $
Other major obligation; include monthly amount:

Personal References
Personal Reference (Hawaii Resident):	Telephone:	Personal Reference (Hawaii Resident):	Telephone:
Name of nearest living relative:	Relationship:	Address:	Telephone:
In case of emergency, notify:	Relationship:	Address:	Telephone:
I authorize Kauai Rentals & Real Estate to obtain & verify information about the income, assets, personal data & conduct of all persons listed on my application. Sources of such information may include but are not limited to employers, social workers, welfare workers, landlords, resident/housing managers, parole officers, court and criminal records, drug treatment centers, clinics, physicians or police department. I hereby authorize consumer reporting agencies to provide you with consumer reports relating to me. I hereby give permission for Kauai Rentals & Real Estate and TBL RentCheck to verify the above information. I understand that if any of the information provided is later found to be fraudulent, the Landlord has the right to terminate my lease agreement immediately. I have read the above form and I understand that if I cause a financial loss to the Landlord that my name may be placed in the files of TBL RentCheck and such information will be furnished to subscribers who have a bona fide and legal need to make an inquiry. I also understand that causing a financial loss may limit by ability to obtain credit or to lease other dwelling units.

4253 Rice Street, Suite B
Lihue, HI 96766
808-245-3343 office
808-245-3320 fax
www.kauairr.com

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