Kansas Rental Application

Property Applying For:
[[Full Rental Property Address]]
[[City]], Kansas [[ZIP Code]]
Unit: [[Unit/Apt Number]]
Monthly Rent: $[[Monthly Rent Amount]]
Security Deposit: $[[Security Deposit Amount]]
Application Date: [[Application Date]]

Landlord / Property Manager:
[[Landlord or Management Company Name]]
[[Address]]
[[City]], Kansas [[ZIP Code]]
Phone: [[Phone]] | Email: [[Email for Applications]]

Application Fee: $[[Application Fee Amount]] (non-refundable; covers actual costs of credit and background screening), -

Applicant Information (Primary Applicant)

Full Legal Name: [[First Middle Last]]

Date of Birth: [[MM/DD/YYYY]] | SSN (last 4 or full for screening): [[XXX-XX-XXXX]]

Current Address: [[Street, City, State, ZIP]] | How long: [[Years/Months]]

Home Phone: [[ ]] | Cell: [[ ]] | Email: [[ ]]

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

Co-Applicant / Additional Adult Occupant (if any):
Name: [[ ]] DOB: [[ ]] SSN: [[ ]] Relationship: [[ ]]

All Proposed Occupants (including children):
1. [[Name, Age, Relationship]]
2. [[Name, Age, Relationship]]
[[Add lines as needed]]

Emergency Contact:
[[Name, Relationship, Phone, Address]], -

Residency History (Past 3 Years, List All Addresses)

Have you ever been evicted or had an unlawful detainer filed against you? [[Yes / No]], If yes, explain: [[ ]]

Have you ever been asked to vacate or had a lease terminated early? [[Yes / No]], Details: [[ ]], -

Employment and Income Verification

Current Employer:
[[Company Name]]
[[Address]]
[[Supervisor / HR Contact Name and Phone]]
Position: [[ ]] | Dates Employed: [[From - Present]]
Gross Monthly Income: $[[ ]]

Previous Employer (if current < 2 years):
[[Company]] | [[Contact]] | Dates: [[ ]] | Gross Monthly: $[[ ]]

Other Income Sources (SSI, child support, alimony, investments, etc., list):
[[Source and Monthly Amount]]

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

Banking / Financial:
Bank: [[Name]] | Checking / Savings Account Numbers (last 4): [[ ]], -

Credit and Background Screening Authorization (FCRA)

I/We authorize the Landlord, its agents, or a consumer reporting agency to obtain one or more consumer reports, credit reports, criminal background checks, eviction history, and other information for tenant screening purposes.

This authorization is valid for the processing of this application and for any updates or re-screening during the tenancy as permitted by law.

I/We understand that:

• The report(s) will be used solely for housing decisions.
• I/We have the right to obtain a copy of any report and to dispute inaccurate information directly with the reporting agency.
• Providing false information on this application is grounds for denial or termination of tenancy.

FCRA Notice: If any adverse action is taken based in whole or in part on information in a consumer report, the Landlord will provide the name, address, and telephone number of the consumer reporting agency and a statement of rights under the Fair Credit Reporting Act.

Applicant Signature for Authorization: ____________________________ Date: [[ ]]

Co-Applicant: ____________________________ Date: [[ ]], -

Screening Criteria Disclosure

Landlord uses objective, uniformly applied criteria to evaluate all applicants. Denial or approval is based on the following (subject to individualized assessment for criminal records per HUD guidance):

Income: Combined gross monthly income must be at least [[e.g. 3.0]] times the monthly rent (or other standard applied consistently).

Credit: Minimum credit score [[e.g. 580 or acceptable alternative history]]. No recent bankruptcies, collections related to housing, or excessive negative items without explanation.

Rental History: Positive references from prior landlords; no evictions within [[e.g. 5]] years; no history of lease violations or property damage.

Criminal Background: Convictions are evaluated on an individualized basis considering:
- Nature and severity of the offense
- Time elapsed since offense
- Age at time of offense
- Evidence of rehabilitation
- Relationship of offense to safety of residents/property

Certain offenses (e.g., those involving violence, sexual misconduct, or manufacture/distribution of controlled substances) may result in denial after individualized review.

Other Factors: Number of occupants relative to unit size (consistent with local codes and Fair Housing); pets (see below); vehicles; and completeness/accuracy of application.

Applicants will be notified of approval, conditional approval, or denial in writing. Denied applicants will receive the reasons and information on how to obtain a copy of any consumer report used., -

Application / Screening Fee Disclosure

Application fee of $[[Application Fee Amount]] per adult applicant is charged to cover the actual costs of obtaining credit reports, background checks, eviction searches, and processing.

Fee is non-refundable once screening has commenced.

No statutory cap exists in Kansas (K.S.A. 58-2550); fee reflects documented actual costs.

Additional fees may apply for pets, parking, or other amenities if approved., -

Pets, Occupants, Vehicles, and Other

Pets: [[None / List type, breed, weight, age, number]]
Pet deposit or fee (if applicable): $[[ ]]

Vehicles:
Make/Model/Year/License: [[ ]]
Parking space requested: [[ ]]

Smoking Policy at Property: [[Non-smoking / Designated areas only]]

Water-filled furniture or other special items: [[None / Describe]], -

Fair Housing and Nondiscrimination Notice

This property is offered in compliance with the federal Fair Housing Act (42 U.S.C. § 3601 et seq.) and Kansas law. We do not discriminate on the basis of race, color, religion, sex, national origin, familial status, disability, or any other protected class.

All applications are processed using the same objective criteria. Reasonable accommodations and modifications will be considered for applicants with disabilities upon request.

Criminal screening follows current HUD guidance on the use of arrest and conviction records (individualized assessment required; blanket bans based solely on arrest or certain conviction categories without consideration of mitigating factors are disfavored).

If you believe you have been discriminated against, you may file a complaint with the U.S. Department of Housing and Urban Development (HUD) or the Kansas Human Rights Commission., -

Authorization and Certification

I/We certify that all information provided in this application is true, complete, and accurate to the best of my/our knowledge. I/We understand that any false statement or omission may result in denial of this application or termination of any tenancy granted.

I/We authorize verification of all information, including contacting current and prior landlords, employers, and obtaining consumer reports as described.

I/We have received and read the screening criteria and fee disclosure.

Primary Applicant Signature:
____________________________________________ Date: [[Date]]
Print Name: [[Full Name]]

Co-Applicant / Additional Adult:
____________________________________________ Date: [[Date]]
Print Name: [[Full Name]]

Received by Landlord / Agent:
____________________________________________ Date: [[Date]]
Print Name / Title: [[ ]], -

Numbered Application Processing Steps

1. Applicant completes and signs all sections of this form.
2. Applicant pays non-refundable application fee.
3. Landlord orders credit, background, and reference checks.
4. Landlord applies screening criteria consistently to all applicants.
5. Landlord provides written decision (approval, conditional, or denial with reasons).
6. Approved applicant signs lease and pays required deposits/fees.
7. Move-in inspection and keys issued., -

Kansas Rental Application Statutory Notes

• K.S.A. 58-2550: Landlords may charge application fees; no statutory maximum; must reflect actual costs of screening.
• Fair Housing Act and HUD guidance govern use of criminal records in housing decisions, individualized assessment required.
• All protected classes under federal and state law are respected.
• Information obtained is used only for housing decisions and handled in accordance with FCRA and privacy laws., -

Disclaimer and Sources

Template, not professional legal advice. This is a model rental application form for use in Kansas. It complies with K.S.A. 58-2550 regarding fees and with federal Fair Housing requirements. Criminal screening must be conducted using individualized assessment per current HUD guidance. Landlords should consult counsel or a qualified compliance professional to ensure their specific screening policy and criteria do not have a disparate impact on protected classes. Forms and policies should be reviewed regularly for legal updates as of June 2026.

Sources (as of June 2026):
- Kansas Residential Landlord and Tenant Act, K.S.A. 58-2540 et seq. (particularly K.S.A. 58-2550)
- Fair Credit Reporting Act (FCRA), 15 U.S.C. § 1681 et seq.
- Fair Housing Act, 42 U.S.C. § 3601 et seq. and HUD guidance on criminal records (2016 and subsequent)
- Kansas Human Rights Commission guidance
- Kansas Revisor of Statutes, -

End of Kansas Rental Application