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 *
    YesNo
    Indoor
    YesNo
    Outdoor
    YesNo
    Do you smoke? *
    YesNo
    Are you or any household member subject to a lifetime registration as a sex offender? *
    YesNo

    Have you ever:
    Filed for bankruptcy? *
    YesNo
    Been Sued? *
    YesNo
    Been evicted? *
    YesNo
    Been convicted of a crime? *
    YesNo

    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.