Connecticut Rental Application Template
This Rental Application is tailored to align with the specific requirements and protections under the Connecticut Fair Housing Act and the Connecticut Landlord and Tenant Act. It is designed to gather necessary information from prospective tenants in a manner that is compliant with state laws. Please complete all sections accurately.
Applicant Information
Full Name: ___________________________________________
Date of Birth: ___________________________________________
Social Security Number: ___________________________________________
Phone Number: ___________________________________________
Email Address: ___________________________________________
Current Address: ___________________________________________
City/State/Zip: ___________________________________________
Drivers License Number and State: ___________________________________________
Rental History
Current Landlord's Name: ___________________________________________
Landlord's Phone Number: ___________________________________________
Monthly Rent: $___________________________________________
Reason for Leaving: ___________________________________________
Previous Address: ___________________________________________
City/State/Zip: ___________________________________________
Previous Landlord's Name: ___________________________________________
Landlord's Phone Number: ___________________________________________
Employment Information
Current Employer: ___________________________________________
Employer Address: ___________________________________________
City/State/Zip: ___________________________________________
Position: ___________________________________________
Supervisor's Name: ___________________________________________
Supervisor's Phone Number: ___________________________________________
Annual Income: $___________________________________________
References
- Name: ___________________________________________ Phone: ___________________________________________ Relationship: ___________________________________________
- Name: ___________________________________________ Phone: ___________________________________________ Relationship: ___________________________________________
- Name: ___________________________________________ Phone: ___________________________________________ Relationship: ___________________________________________
Consent for Background Check
By signing this application, I give consent to the landlord or property manager to conduct a background and credit check. I certify that the information provided is true to the best of my knowledge.
Applicant's Signature: ___________________________________________ Date: _______________
Notice
Connecticut state law requires landlords to provide prospective tenants with specific disclosures, such as lead-based paint disclosures for properties built before 1978. Ensure you receive and review these disclosures before signing a lease agreement.