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    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.