Iowa Rental Application

This Iowa Residential Rental Application is governed by Iowa Code Chapter 562A (Uniform Residential Landlord and Tenant Act). Landlords may charge an application or screening fee only to the extent of actual out-of-pocket costs incurred to obtain and process consumer reports or background information. No fee may be charged in excess of those actual costs. Before obtaining a consumer credit report or criminal background check, the landlord must obtain the applicant's written consent and provide the required disclosures under the federal Fair Credit Reporting Act (FCRA) and applicable Iowa law. All screening criteria must be applied consistently and in compliance with the federal Fair Housing Act and Iowa Civil Rights Act.

The completed application, together with any required fee and authorizations, will be used solely for tenant screening purposes in connection with the rental of the property identified below., -

Section 1, Property and Tenancy Information

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

Unit or Apartment Number (if applicable): [[Unit Number]]

Type of Unit: [[Single Family Home / Duplex / Apartment / Condo / Townhome / Other]]

Number of Bedrooms: [[Number of Bedrooms]]

Number of Bathrooms: [[Number of Bathrooms]]

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

Security Deposit Amount (if known): $[[Security Deposit Amount]]

Lease Term Requested: [[12 Months / 6 Months / Month-to-Month / Other: ________]]

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

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

Contact Phone: [[Landlord Phone Number]]

Contact Email: [[Landlord Email]]

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

Section 2, Applicant Information (Primary Applicant)

All adult occupants (18 years or older) must submit a separate application or be listed as co-applicant with consent.

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

Date of Birth: [[Date of Birth]]

Social Security Number (last 4 for ID verification; full SSN only if separate consent form used): [[SSN Last 4 or Full if consented]]

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

Current Phone (Primary): [[Primary Phone Number]]

Current Phone (Alternate): [[Alternate Phone Number]]

Email Address: [[Email Address]]

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

Length of Time at Current Address: [[Years and Months]]

Reason for Leaving Current Residence: [[Reason for Leaving]]

Are you a U.S. Citizen or Lawful Permanent Resident? [[Yes / No, if No, provide immigration status details: [[Immigration Status Details]] ]], -

Section 3, Co-Applicants and Other Adult Occupants

List every adult (18+) who will reside in the unit. Each must complete an application or be joined here with full consent.

1. Co-Applicant Full Legal Name: [[Co-Applicant 1 Full Legal Name]]

Date of Birth: [[Co-Applicant 1 DOB]]

Relationship to Primary: [[Relationship]]

Phone: [[Co-Applicant 1 Phone]]

2. Co-Applicant Full Legal Name: [[Co-Applicant 2 Full Legal Name]]

Date of Birth: [[Co-Applicant 2 DOB]]

Relationship to Primary: [[Relationship]]

Phone: [[Co-Applicant 2 Phone]]

3. Additional Occupant (if any): [[Additional Adult Occupant Name and DOB]], -

Section 4, Residency History (Previous 3 Years Minimum)

Provide complete addresses for the last three years. Attach additional pages if necessary.

Current Residence (if different from mailing)

Address: [[Current Residence Address]]

Landlord/Owner Name: [[Current Landlord Name]]

Landlord Phone: [[Current Landlord Phone]]

Monthly Rent Paid: $[[Current Rent Amount]]

Dates Occupied: [[Move In Date]] to [[Present or Move Out Date]]

Reason for Leaving: [[Reason]]

May we contact? [[Yes / No, Explain if No: [[Explanation]]]]

Previous Residence 1

Address: [[Previous Residence 1 Full Address]]

Landlord/Owner Name: [[Previous Landlord 1 Name]]

Landlord Phone: [[Previous Landlord 1 Phone]]

Monthly Rent: $[[Previous Rent 1]]

Dates: [[Start Date]] to [[End Date]]

Reason for Leaving: [[Reason]]

May we contact? [[Yes / No]]

Previous Residence 2

Address: [[Previous Residence 2 Full Address]]

Landlord/Owner Name: [[Previous Landlord 2 Name]]

Landlord Phone: [[Previous Landlord 2 Phone]]

Monthly Rent: $[[Previous Rent 2]]

Dates: [[Start Date]] to [[End Date]]

Reason for Leaving: [[Reason]]

May we contact? [[Yes / No]]

Previous Residence 3 (if applicable)

Address: [[Previous Residence 3 Full Address]]

Landlord/Owner Name: [[Previous Landlord 3 Name]]

Landlord Phone: [[Previous Landlord 3 Phone]]

Monthly Rent: $[[Previous Rent 3]]

Dates: [[Start Date]] to [[End Date]], -

Section 5, Employment and Income Information

Current Employer: [[Current Employer Name]]

Employer Address: [[Employer Street, City, State, ZIP]]

Position/Title: [[Job Title]]

Supervisor or HR Contact: [[Supervisor Name]]

Supervisor Phone: [[Supervisor Phone]]

Length of Employment: [[Years / Months]]

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

Other Income Sources (alimony, child support, investments, side business, etc.): [[Other Income Description]] Amount: $[[Other Monthly Income]]

Previous Employer (if current < 2 years): [[Previous Employer Name]] Dates: [[Dates]] Income: $[[Amount]]

If Self-Employed or Retired: Provide business name, tax returns summary, or retirement benefit details: [[Self-Employment or Retirement Details]]

Total Combined Monthly Household Income (all applicants): $[[Total Household Monthly Gross Income]], -

Section 6, Financial and Credit Information

Bank Name and Branch: [[Bank Name]]

Checking Account Number (last 4): [[Checking Last 4]]

Savings Account (last 4): [[Savings Last 4]]

Do you have any outstanding judgments, collections, or bankruptcies in the last 7 years? [[Yes / No, If Yes, explain: [[Bankruptcy or Judgment Explanation]]]]

Have you ever been evicted or had an eviction filed against you? [[Yes / No, Details and dates: [[Eviction Details]]]], -

Section 7, Rental Application and Screening Fee Disclosure (Iowa)

Pursuant to Iowa Code Chapter 562A and FCRA requirements:

The fee of $[[Application Screening Fee Amount]] is charged solely to cover the actual costs of obtaining and processing consumer credit reports, criminal background checks, and related screening services from third-party providers.

This fee is non-refundable once screening has begun, except to the extent required by law or the landlord's written policy.

You will receive a copy of any consumer report obtained upon request, as required by the FCRA.

Landlord will not charge more than actual documented screening costs.

[[Additional Fee Notes or Itemization if Multiple Applicants]], -

Section 8, Authorization and Consent for Background and Credit Screening

IMPORTANT, READ BEFORE SIGNING

I/we authorize [[Landlord or Property Manager Full Name]] and/or its agents to obtain consumer credit reports, criminal background reports, eviction history, employment verification, and rental reference information from any consumer reporting agency, landlord, employer, or other source.

This authorization is given pursuant to the federal Fair Credit Reporting Act and Iowa law. I understand that:

1. A consumer report may be obtained for tenant screening purposes in connection with my/our application to rent the property at [[Property Street Address]].

2. If the landlord takes adverse action (denial, higher deposit, or other) based in whole or in part on information in a consumer report, I will be provided: (a) notice of the adverse action; (b) the name, address, and telephone number of the consumer reporting agency; and (c) a statement of my rights under the FCRA.

3. I may obtain a free copy of the report within 60 days of adverse action.

4. The information obtained will be used only for the stated rental decision and will be kept confidential to the extent permitted by law.

Written Consent:

Primary Applicant Signature / Printed Name: _______________________________ Date: [[Date]]

Co-Applicant 1 Signature / Printed Name: _______________________________ Date: [[Date]], -

Section 9, Screening Criteria (Objective Standards)

The landlord uses the following objective, uniformly applied criteria. Failure to meet one or more may result in denial or additional requirements (e.g., co-signer or higher deposit). All criteria comply with fair housing laws.

1. Income: Combined gross monthly household income must equal or exceed [[Income Multiple, e.g. 3.0]] times the monthly rent.

2. Credit Score: Minimum FICO score of [[Minimum Credit Score Threshold, e.g. 620]] (or explanation of compensating factors).

3. Rental History: No evictions within the past [[X years]]; no more than [[Y]] late payments or lease violations in past 3 years without satisfactory explanation.

4. Criminal History: Individualized assessment performed; automatic denial only for certain serious convictions (drug manufacturing, violent crimes, sex offenses on registry) within relevant look-back periods consistent with HUD guidance. All other records reviewed for relevance, recency, and rehabilitation.

5. False Information: Any material misrepresentation or omission on this application is grounds for denial or lease termination., -

Section 10, Pets, Occupants, Vehicles, and Special Requests

Pets: [[No pets / 1 dog / 1 cat / Other, specify breed, weight, age: [[Pet Details]] ]]

Service or Assistance Animals: [[None / Describe animal and documentation: [[Assistance Animal Details]] ]]

Additional Occupants under 18: [[Names and ages of minor children: [[Minor Occupants]] ]]

Vehicles: Number: [[Number of Vehicles]] Make/Model/Year/License: [[Vehicle 1 Details]] [[Vehicle 2 Details]]

Smoking Policy Acknowledgment: [[Non-smoking unit / Designated outdoor area only]]

Other Requests or Accommodations: [[Reasonable Accommodation or Modification Requests]], -

Section 11, Fair Housing and Nondiscrimination Notice (Federal + Iowa)

This property is offered in compliance with the federal Fair Housing Act and the Iowa Civil Rights Act (Iowa Code Chapter 216).

We do not discriminate on the basis of race, color, religion, sex, national origin, familial status, disability, sexual orientation, gender identity, or any other protected class under applicable federal, state, or local law.

If you believe you have been discriminated against, you may contact the Iowa Civil Rights Commission or the U.S. Department of Housing and Urban Development., -

Section 12, Applicant Certification and Signature

I/we certify under penalty of perjury that all 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 the application or termination of any lease.

I acknowledge receipt of this application's fee disclosure and consent to screening as described.

1. Primary Applicant:

Signature: _______________________________ Printed Name: [[Applicant Full Legal Name]] Date: [[Date]]

2. Co-Applicant 1:

Signature: _______________________________ Printed Name: [[Co-Applicant 1 Full Legal Name]] Date: [[Date]]

3. Co-Applicant 2:

Signature: _______________________________ Printed Name: [[Co-Applicant 2 Full Legal Name]] Date: [[Date]], -

Landlord / Agent Use Only

Date Received: [[Date Received]]

Fee Paid: $[[Fee Amount Paid]] Method: [[Cash / Check # / Credit Card / Other]]

Screening Ordered: [[Date]]

Report Received: [[Date]]

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

Notes: [[Internal Notes, do not share with applicant]], -

*Iowa Rental Application template, not legal advice. All screening fees, consent procedures, and criteria must comply with Iowa Code Chapter 562A, the federal Fair Credit Reporting Act, and fair housing laws as of 2026-06. Verify current statutes and consult qualified counsel for your specific situation before use. Invented values use [[Token Name]] placeholders.*