Indiana Rental Application

Date of Application: [[Application Date]]

Property Address: [[Street Address]], [[City]], Indiana [[ZIP Code]]

Unit (if applicable): [[Unit Number or "N/A"]]

Advertised Monthly Rent: $[[Monthly Rent Amount]]

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

Lease Term Requested: [[Month-to-Month / 12 Months / Other]]

Landlord / Property Manager: [[Landlord or Property Manager Full Name]]

Phone: [[Landlord Phone]] | Email: [[Landlord Email]]

Indiana Code IC 32-31-8 (Indiana Tenant's Rights Law) and related provisions govern landlord-tenant relations. There is no statutory cap on application or screening fees in Indiana; however, the amount and non-refundability must be disclosed in writing before collection. FCRA-compliant consent is required for credit and background checks. All screening criteria must be applied uniformly and must comply with the federal Fair Housing Act (FHA) and Indiana fair housing laws. Landlords may not discriminate on the basis of protected classes (race, color, religion, sex, national origin, familial status, disability, and other classes protected under Indiana law).

This application collects the information needed to evaluate tenancy applications in a compliant manner. All fees are disclosed below. Applicant must sign the authorization sections., -

1. Applicant Personal and Contact Information

*All applicants age 18 and older who will reside in the unit must submit a separate application.*

Full Legal Name: [[Full Legal Name of Applicant]]

Date of Birth: [[Date of Birth]]

Social Security Number (last 4 for verification; full SSN may be requested separately for screening): [[Last 4 SSN or "Will provide under separate secure channel"]]

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

Primary Phone: [[Primary Phone]] Alternate Phone: [[Alternate Phone]]

Email Address: [[Email Address]]

Current Mailing Address: [[Current Street, City, State, ZIP]]

How long at current address? [[Years / Months]] Reason for leaving: [[Reason]]

Emergency Contact Name: [[Emergency Contact Full Name]]

Relationship: [[Relationship]] Phone: [[Emergency Phone]], -

2. Additional Occupants

List all other persons (including children) who will reside at the property:

3. Residency History (Last 3 Years)

Provide complete history. Use additional sheets if needed.

Current / Most Recent Residence

• Address: [[Address, City, State, ZIP]]

• Landlord / Manager Name: [[Landlord Name]]

• Landlord Phone / Email: [[Contact]]

• Monthly Rent: $[[Rent Amount]]

• Dates of Occupancy: [[From Date]] to [[To Date]]

• Reason for leaving: [[Reason]]

Previous Residence 2

• Address: [[Address, City, State, ZIP]]

• Landlord / Manager: [[Name]] Phone: [[Phone]]

• Rent: $[[Amount]] Dates: [[From]] to [[To]]

• Reason for leaving: [[Reason]]

Previous Residence 3

• Address: [[Address, City, State, ZIP]]

• Landlord / Manager: [[Name]] Phone: [[Phone]]

• Rent: $[[Amount]] Dates: [[From]] to [[To]]

• Reason for leaving: [[Reason]], -

4. Employment and Income Information

Current Employer: [[Employer Name]]

Position / Title: [[Job Title]]

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

Employer Address: [[Address]]

Length of Employment: [[Years / Months]] Monthly Gross Income: $[[Gross Monthly Income]]

Other Income Sources (alimony, child support, investments, etc., voluntary disclosure): [[Other Income Description or "None"]]

Previous Employer (if current < 2 years): [[Name]] Dates: [[From]] to [[To]]

Income from previous: $[[Amount per month]], -

5. Application / Screening Fee Disclosure

Application / Screening Fee Amount: $[[Fee Amount]]

Non-Refundable: [[Yes, the fee covers the actual costs of screening and is non-refundable regardless of approval or denial / No, refundable under the following conditions: [[Conditions]] ]]

The fee is disclosed in writing before collection as required. No statutory maximum exists in Indiana; the fee must be reasonable and related to actual screening costs (credit report, background check, etc.). Applicant acknowledges the fee and its non-refundability before submitting this application.

Payment Method for Fee: [[Cash / Check / Money Order / Online Payment]], -

6. FCRA Authorization and Consent for Credit and Background Screening

IMPORTANT DISCLOSURE UNDER THE FAIR CREDIT REPORTING ACT (FCRA)

A consumer report and/or investigative consumer report may be obtained on Applicant for tenancy screening purposes. The report may include credit history, criminal records, eviction history, employment verification, and other information.

Applicant authorizes Landlord or its screening agent to obtain such reports. Applicant has the right to request a copy of any report obtained and to dispute inaccurate information with the consumer reporting agency.

By signing below, Applicant:

1. Consents to procurement of consumer report(s) and background check(s).

2. Authorizes verification of all information provided herein.

3. Certifies that all statements are true and complete.

Applicant Signature for FCRA Consent: ________________________________ Date: [[Application Date]]

Printed Name: [[Full Legal Name of Applicant]], -

7. Screening Criteria (Objective Standards)

Landlord applies the following objective, uniformly applied criteria. Failure to meet one or more may result in denial or conditional approval (e.g., higher deposit or co-signer).

• Income: Minimum monthly gross income of [[Income Multiple, e.g., 3.0]] times the monthly rent (or combined for all applicants).

• Credit Score: Minimum [[Minimum Credit Score, e.g., 620]] (or explanation of adverse items required).

• Rental History: No evictions within [[Eviction Lookback Period, e.g., 5]] years. No outstanding balances owed to prior landlords.

• Criminal History: Individualized assessment per HUD guidance. Convictions for [[List Disqualifying Crimes, e.g., violent felonies, drug manufacturing, sex offenses requiring registration]] within [[Lookback Period, e.g., 7]] years may result in denial. Arrests without conviction generally not considered.

• Other: No more than [[Max Pets]] pets; compliance with occupancy limits per local code (generally [[Max Occupants]] persons).

Applicant may provide explanations or mitigating information for any adverse item., -

8. Pets, Vehicles, and Other

Pets: [[No pets / One dog or cat / Other, describe]]

Pet Deposit or Fee (if any and permitted): $[[Amount or "N/A"]]

Vehicles: Number of vehicles: [[Number]] Make/Model/Plate: [[Details]]

Smoking: [[Non-smoking property / Smoking permitted outdoors only / Other]], -

9. Fair Housing Notice

Landlord complies with the federal Fair Housing Act and Indiana fair housing laws. We do not discriminate on the basis of race, color, religion, sex, national origin, familial status, disability, or any other protected class under applicable law. All criteria are applied uniformly. If you believe you have been discriminated against, you may contact the U.S. Department of Housing and Urban Development (HUD) or the Indiana Civil Rights Commission., -

10. Applicant Certification and Signature

I certify that the information provided in this application is true, complete, and accurate to the best of my knowledge. I understand that any false statement may result in denial of tenancy or termination of any lease entered.

I have read and understand the fee disclosure, FCRA authorization, and screening criteria.

Applicant Signature: ________________________________ Date: [[Application Date]]

Printed Name: [[Full Legal Name]]

Co-Applicant Signature (if separate application not used): _______________________________ Date: _______

Printed Name: [[Name]], -

11. For Landlord Use Only

Application Received Date: _______ **Fee Received:** $_______

Screening Ordered Date: _______ **Report Received Date:** _______

Decision: [[Approved / Approved with Conditions / Denied]]

Conditions / Reason (if applicable): [[Notes, must be consistent with criteria]]

Lease Prepared Date: _______ **Move-In Date Scheduled:** _______, -

Template example, not professional (legal/financial/medical) advice. This rental application form complies with Indiana law (IC 32-31-8 and related) and federal FCRA / Fair Housing requirements. Fees must be disclosed in writing before collection. Screening criteria must be objective and applied consistently. Verify current law and consult counsel for your specific use. Sources: IC 32-31-8; 15 U.S.C. § 1681 et seq. (FCRA); 42 U.S.C. § 3601 et seq. (FHA) (as of 2026).

> ⚠️ Template example, not professional (legal/financial/medical) advice. Figures and clauses must be verified for the applicable jurisdiction and kept current.