Kentucky Rental Application

Property Address: [[Property Full Street Address]], [[City]], Kentucky [[ZIP Code]]
County: [[County Name]]
Monthly Rent: $[[Monthly Rent Amount]]
Security Deposit (if known at application): $[[Security Deposit Amount]]
Desired Move-In Date: [[Desired Move-In Date]]
Lease Term: [[12 months / 6 months / Month-to-month / Other]]
Application / Screening Fee: $[[Application Fee Amount]] (non-refundable unless otherwise required by local ordinance)

Landlord / Property Manager / Owner: [[Landlord or Management Company Full Name]]
Mailing Address for Notices: [[Landlord / Agent Mailing Address]]
Phone: [[Phone]] | Email: [[Email]]

This Rental Application is submitted for the purpose of evaluating the Applicant(s) for tenancy at the Property. All information will be used solely for screening in accordance with the federal Fair Housing Act, the Fair Credit Reporting Act (FCRA), the Kentucky Civil Rights Act (KRS Chapter 344), and other applicable law. Kentucky imposes no statewide cap on application or screening fees. The fee above reflects the actual costs of obtaining consumer reports, background checks, eviction history, reference verification, and administrative processing. The fee is generally non-refundable regardless of the decision.

Important Disclosures and Applicant Rights

Fair Housing Compliance: Landlord does not discriminate on the basis of race, color, religion, sex (including gender identity and sexual orientation), national origin, familial status, disability, or any other protected class under the federal Fair Housing Act or the Kentucky Civil Rights Act (KRS 344). All screening criteria are applied consistently and objectively.

Consumer Reports / FCRA Notice: A consumer report (credit report, criminal background check, eviction search, rental history, employment/income verification) may be obtained from one or more consumer reporting agencies. You have the right under the FCRA to obtain a copy of any report obtained about you and to dispute inaccurate information. If an adverse action (denial, conditional approval, or increased deposit requirement) is taken based in whole or in part on information in a consumer report, you will receive an adverse action notice containing a copy of the report and a written summary of your FCRA rights.

Application Fee: The fee is non-refundable except where a local ordinance or specific written agreement requires a refund. The fee covers screening costs already incurred or committed.

No Tenancy Created: Submission of this application does not create a tenancy, lease, or guarantee of approval. Landlord reserves the right to accept or reject any application based on objective, consistently applied criteria.

Screening Criteria Summary (disclosed for transparency):
- Income: Minimum gross monthly income typically [[2.5x / 3x]] the monthly rent (or other disclosed multiple).
- Credit: Minimum credit score and/or review of credit history for payment patterns, collections, and bankruptcies.
- Rental History: Positive references from prior landlords; no evictions or substantial lease violations within [[X]] years.
- Criminal Background: Convictions for certain crimes (violent, property, drug distribution, sex offenses) may result in denial; individualized assessment performed where required by law.
- Other: Verifiable identity, legal right to reside in the U.S. if required for program participation, and absence of material misrepresentations., -

1. Applicant(s) Information

Primary Applicant Full Legal Name: [[Primary Applicant Full Legal Name]]
Date of Birth: [[MM/DD/YYYY]]
Social Security Number: [[Full SSN, will be redacted after screening]]
Driver's License / State ID: [[State and Number]]
Current Phone: [[Phone]]
Current Email: [[Email]]
Current Address: [[Street, City, State, ZIP]], How long: [[Months/Years]]
Reason for Leaving: [[Reason]]
Landlord / Manager at Current Address: [[Name]] Phone: [[Phone]] Email: [[Email]]

Previous Address (last 2, 5 years):
[[Street, City, State, ZIP]], Dates: [[From, To]]
Landlord: [[Name]] Phone: [[Phone]]

Additional Applicant(s) / Household Members (list all adults and minors who will reside):
1. [[Full Name]], DOB: [[MM/DD/YYYY]], Relationship: [[Spouse / Partner / Child / Other]]
2. [[Full Name]], DOB: [[MM/DD/YYYY]], Relationship: [[...]]
[[Add lines as needed]], -

2. Employment and Income

Current Employer: [[Employer Name]]
Employer Address: [[Address]]
Position / Title: [[Job Title]]
Dates Employed: [[From, To or Present]]
Supervisor / HR Contact: [[Name]] Phone: [[Phone]]
Gross Monthly Income (before taxes): $[[Amount]]
Other Income Sources (child support, alimony, disability, investments, gig work, etc.): $[[Amount]], Source: [[Describe, note: only voluntary disclosure of non-employment income]]

Previous Employer (if current < 2 years): [[Name]], Dates: [[From, To]], Gross Monthly: $[[Amount]]

Co-Applicant / Other Adult Household Income (if applicable):
Name: [[Name]], Employer: [[Employer]], Gross Monthly: $[[Amount]]

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

Income Documentation to be Provided: [[Pay stubs (last 30, 60 days) / W-2s / Tax returns / Bank statements / Award letters / Other]], -

3. Rental / Housing History

Current Landlord / Property Manager Name: [[Name]]
Phone / Email: [[Contact Info]]
Monthly Rent Paid: $[[Amount]], On time? [[Yes / No, explain any issues]]

Prior Landlord (most recent previous): [[Name]] Phone: [[Phone]]
Address Rented: [[Address]], Dates: [[From, To]], Rent: $[[Amount]]

Have you ever been evicted or had an eviction filed against you? [[Yes / No]], If yes, explain: [[Details, dates, outcome]]

Have you ever broken a lease or been asked to vacate? [[Yes / No]], If yes, explain: [[Details]]

Have you ever filed for bankruptcy? [[Yes / No]], If yes, chapter and discharge date: [[Details]], -

4. Credit, Criminal, and Civil History

Credit History Authorization: I authorize the procurement of my credit report and consumer reports as part of this application.

Criminal History (convictions only, do not include arrests not resulting in conviction):
Have you ever been convicted of a felony or misdemeanor (other than minor traffic)? [[Yes / No]]
If yes, list offense(s), year(s), jurisdiction(s), and current status: [[Details]]

Sex Offender Registry: Are you required to register as a sex offender in any jurisdiction? [[Yes / No]]

Outstanding Judgments or Collections Related to Housing: [[Yes / No]], If yes, describe: [[Details]]

Landlord will conduct an individualized assessment of any criminal history in accordance with applicable fair-housing guidance. You may provide additional information or mitigating circumstances for consideration., -

5. Occupants, Pets, and Vehicles

Number of Occupants Who Will Reside at Property: [[Number]] (including Applicant)

Pets (if permitted at Property):
Type/Breed/Weight: [[e.g. 1 dog, Labrador, 45 lbs]], Number: [[Number]]
Service or assistance animal? [[Yes / No]], If yes, describe: [[Type, documentation will be requested separately]]

Vehicles to be parked at Property (if parking provided):
1. [[Year / Make / Model / Color / License Plate]]
2. [[...]]

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

6. Emergency Contacts and References

Emergency Contact (not residing with you):
Name: [[Full Name]], Relationship: [[Relationship]], Phone: [[Phone]]

Personal Reference (not family member or prior landlord):
Name: [[Name]], Phone: [[Phone]], How long known: [[Years]]

Professional Reference:
Name: [[Name]], Phone: [[Phone]], Relationship: [[Employer / Colleague / Other]], -

7. Additional Questions and Certifications

Have you or any household member ever been convicted of manufacturing, distributing, or possessing illegal drugs with intent to distribute? [[Yes / No]]

Do you have any pending criminal charges? [[Yes / No]], If yes, explain: [[Details]]

Are you a current or former member of the U.S. military? [[Yes / No]], Branch and status: [[Details]]

Will any part of the rent be paid by a third party, voucher, or subsidy program? [[Yes / No]], If yes, program and administrator: [[Details]]

Have you ever been a party to a lawsuit involving a landlord or property? [[Yes / No]], If yes, explain: [[Details]]

Certification: I certify that all information provided in this application is true, complete, and accurate to the best of my knowledge. I understand that any material misrepresentation or omission may result in denial of the application or termination of any tenancy granted. I authorize verification of all information, including but not limited to credit reports, criminal background checks, eviction searches, employment and income verification, and contact with current and prior landlords and references., -

8. FCRA Authorization and Consumer Report Consent

I authorize Landlord, its agents, employees, and consumer reporting agencies to obtain consumer reports, investigative consumer reports, credit reports, criminal background reports, eviction reports, and any other reports or information necessary to evaluate this application. This authorization is ongoing for the purpose of evaluating this application and, if approved, for ongoing tenancy purposes as permitted by law.

I understand that I have the right to request a copy of any consumer report obtained about me. I further understand that if adverse action is taken based in whole or in part on information in a consumer report, I will be provided (1) notice of the adverse action, (2) a copy of the consumer report, and (3) a summary of my rights under the FCRA.

Applicant Signature (Primary): _______________________________ Date: [[Date]]
Printed Name: [[Primary Applicant Full Legal Name]]

Applicant Signature (Additional Adult): _______________________________ Date: [[Date]]
Printed Name: [[Additional Applicant Full Legal Name]], -

9. Landlord / Agent Use Only (Do Not Complete, For Internal Processing)

Application Received Date: [[Date]]
Fee Received: $[[Amount]], Form: [[Cash / Check # / Card / Other]], Receipt #: [[Number]]

Screening Ordered: Credit: [[Date]], Criminal: [[Date]], Eviction: [[Date]], Other: [[Date]]

References Contacted: Current Landlord [[Date / Outcome]], Prior Landlord [[Date / Outcome]]

Decision: [[Approved / Conditionally Approved / Denied]]
Adverse Action Notice Sent (if applicable): [[Date]], Copy of report provided: [[Yes / No]]

Notes: [[Internal notes, income ratio, red flags, conditions, guarantor required, etc.]]

Processed By: [[Staff Name / Title]] Date: [[Date]], -

10. Fair Housing and Nondiscrimination Statement

This property is offered in compliance with the federal Fair Housing Act and the Kentucky Civil Rights Act (KRS Chapter 344). We do not discriminate on the basis of race, color, religion, sex (including gender identity and sexual orientation), national origin, familial status, disability, or any other characteristic protected by applicable law.

If you believe you have been discriminated against in the application process, you may contact the U.S. Department of Housing and Urban Development (HUD) at 1-800-669-9777 or file a complaint with the Kentucky Commission on Human Rights., -

Sources and Compliance Notes

• Federal Fair Housing Act (42 U.S.C. § 3601 et seq.)
• Fair Credit Reporting Act (15 U.S.C. § 1681 et seq.)
• Kentucky Civil Rights Act, KRS Chapter 344
• KRS 383 (Landlord-Tenant provisions relevant to applications and screening)
• No statewide statutory cap on application fees in Kentucky (as of 2026)
• Local ordinances may impose additional requirements in certain cities or counties

As of June 2026. Screening practices should be reviewed periodically for compliance with current fair-housing guidance regarding criminal background and disparate-impact analysis.

> ⚠️ Template example, not professional legal advice. This document is a sample workflow tool. Every landlord should maintain consistently applied, written screening criteria and consult counsel regarding FCRA, fair-housing, and state-specific obligations. The fee amount and non-refundability should be confirmed against any applicable local ordinance. The user is responsible for lawful use of this template., -

End of Kentucky Rental Application Template