Please call our office once completed to confirm your application was received.  If you are uncomfortable sending this information online, simply contact us and we can fax you an application, or you may download a printable application. After you’ve printed and filled it out fax or mail it to us.

RENTAL APPLICATION

NOTICE TO APPLICANTS: Please furnish all information requested. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED.

How did you hear about this rental?

Pets *
 Yes No
Indoor
 Yes No
Outdoor
 Yes No
Do you smoke? *
 Yes No
Are you or any household member subject to a lifetime registration as a sex offender? *
 Yes No

Have you ever:

Filed for bankruptcy? *
 Yes No
Been Sued? *
 Yes No
Been evicted? *
 Yes No
Been convicted of a crime? *
 Yes No

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 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 also understand that causing a financial loss may limit by ability to obtain credit or to lease other dwelling units.