Hawaii Rental Application

Property Address Applying For: [[Full Street Address, Unit Number]], [[City]], Hawaii [[ZIP Code]]

Monthly Rent: $[[Monthly Rent Amount]]

Application Date: [[Application Date]]

Desired Move-In Date: [[Desired Move-In Date]]

Application / Screening Fee: $[[Fee Amount, reasonable actual costs of screening]] (non-refundable except as required by law or policy), -

This is an application to rent the above Property. All information provided must be true, complete, and accurate. Submission of this application constitutes consent to verification of the information provided, including consumer credit reports, criminal background, eviction history, employment and income verification, and references, in accordance with the federal Fair Credit Reporting Act (FCRA) and applicable Hawaii law.

Hawaii fair housing law (HRS Chapter 515) and the federal Fair Housing Act prohibit discrimination in housing on the basis of race, color, religion, sex (including gender identity and sexual orientation), marital status, familial status, disability, age, ancestry, national origin, or other protected classes under applicable law. This application will be processed using objective, uniformly applied criteria.

1. Applicant Information

1. Full Legal Name of Primary Applicant: [[Primary Applicant Full Legal Name]]

Date of Birth: [[MM/DD/YYYY]]

Social Security Number (last 4 for verification): [[XXX-XX-####]]

Driver's License / State ID: [[State and Number]]

2. Current Address: [[Current Street, City, State, ZIP]]

How long at current address: [[Years / Months]]

Reason for moving: [[Reason]]

3. Phone: [[Primary Phone]]

Email: [[Email Address]]

4. Co-Applicant / Additional Adult Occupant Full Legal Name: [[Co-Applicant Full Legal Name or N/A]]

Relationship to Primary: [[Spouse / Partner / Roommate / Other]]

Date of Birth and contact info: [[Details]]

2. All Proposed Occupants (including children)

List every person who will reside at the Property:

1. [[Full Name]], Age [[Age]], Relationship [[Relationship]]

2. [[Full Name]], Age [[Age]], Relationship [[Relationship]]

3. [[Full Name]], Age [[Age]], Relationship [[Relationship]]

4. [[Full Name]], Age [[Age]], Relationship [[Relationship]]

5. Any additional: [[List or "None"]]

Total number of occupants: [[Number]]

3. Employment and Income History

Primary Applicant Current Employment:

1. Employer Name: [[Employer Name]]

Position / Title: [[Job Title]]

Supervisor / HR Contact: [[Name and Phone]]

Address: [[Employer Address]]

Dates Employed: [[Start Date]] to Present

Monthly Gross Income: $[[Gross Monthly Income]]

Other income sources (SSI, alimony, investments, etc.): $[[Other Income Amount and Source]]

Previous Employment (if current < 2 years):

2. Previous Employer: [[Name]], Dates: [[Dates]], Income: $[[Amount]]

Co-Applicant / Household Employment:

3. Employer: [[Name]], Position: [[Title]], Monthly Gross: $[[Amount]]

4. Other household income: [[Details or None]]

Total Combined Monthly Gross Household Income: $[[Total]]

4. Rental / Housing History (last 5 years or 3 landlords)

1. Current / Most Recent Landlord Name: [[Landlord or Property Manager Name]]

Phone: [[Phone]]

Property Address: [[Address]]

Dates: [[From, To]]

Monthly Rent Paid: $[[Amount]]

Reason for leaving: [[Reason]]

2. Previous Landlord Name: [[Name]]

Phone: [[Phone]]

Address: [[Address]]

Dates and Rent: [[Details]]

3. Previous Landlord Name: [[Name]]

Phone: [[Phone]]

Address: [[Address]]

Dates and Rent: [[Details]]

Have you ever been evicted or had an unlawful detainer filed against you?

[[Yes, details / No]]

Have you ever broken a lease or been asked to leave?

[[Yes, details / No]]

5. Credit and Background Information

1. Have you filed for bankruptcy in the last 7 years?

[[Yes, chapter and discharge date / No]]

2. Have you ever been convicted of a felony? (Note: individualized assessment will be conducted; certain convictions may be considered only as permitted by law)

[[Yes, nature, date, jurisdiction / No]]

3. Are you currently a party to any pending lawsuit or judgment?

[[Yes, details / No]]

6. Pets, Vehicles, and Special Requests

Pets:

• Number and types: [[Number and breeds/types or "None"]]

• Service or assistance animal (documentation will be requested if applicable): [[Yes, type / No]]

Vehicles:

1. [[Make, Model, Year, License Plate]]

2. [[Make, Model, Year, License Plate]]

Additional parking or storage needs: [[Details or None]]

Smoking: [[Non-smoker / Smoker, will smoke only outdoors per rules]]

7. Emergency / Personal References

1. Name: [[Full Name]], Relationship: [[Relationship]], Phone: [[Phone]]

2. Name: [[Full Name]], Relationship: [[Relationship]], Phone: [[Phone]]

3. Name: [[Full Name]], Relationship: [[Relationship]], Phone: [[Phone]]

8. Application / Screening Fee and Consent

I/We understand and agree that:

• A non-refundable application/screening fee of $[[Fee Amount]] is due with this application. This fee covers the actual costs of obtaining consumer reports, background checks, and processing. No statutory cap applies in Hawaii; the fee must be reasonable.

• The fee is payable by [[cash / check / money order / electronic]] to [[Landlord / Management Company Name]].

• By signing below, I/we authorize the Landlord, its agents, and consumer reporting agencies to obtain consumer credit reports, criminal background reports, eviction history, employment and income verification, and to contact landlords, employers, and references listed.

• I/we understand that if any information is found to be false, misleading, or incomplete, this application may be denied and any lease executed may be terminated.

• Adverse action notices (if applicable) will be provided in accordance with the FCRA, including a copy of the report and a summary of rights.

• If this application is for multiple adults, each adult 18+ must submit a separate application or be listed and sign below.

9. Fair Housing Notice, Hawaii HRS Chapter 515 and Federal Law

It is unlawful to discriminate in the sale, rental, or financing of housing on the basis of:

1. Race

2. Color

3. Religion

4. Sex (including gender identity and sexual orientation)

5. Marital status

6. Familial status (families with children under 18)

7. Disability (physical or mental)

8. Age

9. Ancestry

10. National origin

11. Other characteristics protected under Hawaii or federal law (including source of income in certain contexts and military status)

Landlord complies with all applicable fair housing laws. If you believe you have been discriminated against, you may contact the Hawaii Civil Rights Commission, HUD, or a private attorney.

Screening criteria are applied uniformly and include (subject to individualized assessment where required):

• Sufficient income to afford rent and obligations (typically 2.5, 3x rent or as stated)

• Acceptable credit history and debt-to-income

• Positive rental references and payment history

• No recent evictions or patterns of lease violations

• Criminal background reviewed on a case-by-case basis consistent with HUD guidance

10. Additional Disclosures and Acknowledgments

1. I/we have received and reviewed any written rental criteria or screening policy provided.

2. I/we consent to the storage and handling of personal information in accordance with applicable privacy laws.

3. I/we understand that approval is not guaranteed and is based on the information provided and verification results.

4. Any guarantor (if required) must complete a separate guarantor application.

11. Signature(s)

I/we certify under penalty of perjury that all information in this application is true and complete to the best of my/our knowledge.

Primary Applicant Signature:

_______________________________________________ Date: [[Date]]

Printed Name: [[Primary Applicant Full Legal Name]]

Co-Applicant / Additional Adult Signature:

_______________________________________________ Date: [[Date]]

Printed Name: [[Co-Applicant Full Legal Name]]

Landlord / Agent Use Only (do not write above this line)

Date Received: [[Date]]

Fee Received: $[[Amount]], Form: [[Method]]

Application ID: [[Reference]]

Screening ordered: [[Date / Company]]

Decision: [[Approved / Denied / Conditional, conditions]]

Notification sent: [[Date / Method]], -

Sources and Verification (as of June 2026)

• Hawaii Revised Statutes Chapter 515 (Discrimination in Real Property Transactions, 11 protected classes).

• Federal Fair Housing Act (42 U.S.C. §3601 et seq.).

• Fair Credit Reporting Act (15 U.S.C. §1681 et seq.), consumer report requirements and adverse action notices.

• Hawaii Office of Consumer Protection and Civil Rights Commission guidance on tenant screening.

• No statutory cap on application fees in Hawaii; fees must be reasonable and tied to actual costs.

• HUD guidance on criminal background screening and individualized assessments (2016 and updates).

> ⚠️ Template, not professional (legal/financial/medical) advice. This is a template only. Verify current fair housing requirements, screening practices, and fee reasonableness against Hawaii law, local ordinances, and the advice of counsel. Use objective, consistently applied criteria. [[Merge Fields]] indicate user-supplied values., -

End of Hawaii Rental Application