Nevada Rental Application

Property Address: [[Property Full Address]], [[City]], Nevada [[ZIP Code]]
Monthly Rent: [[Monthly Rent Amount]]
Desired Move-In Date: [[Desired Move-In Date]]
Application Date: [[Application Date]]
Application / Screening Fee: [[Application Fee Amount]] (non-refundable; see fee disclosure below)

Landlord / Property Manager: [[Landlord or Management Company Name]]
Contact: [[Landlord Phone]] | [[Landlord Email]]

This Rental Application is used to evaluate applicants for tenancy at the above-referenced property. All information provided will be used solely for screening purposes in accordance with the Fair Credit Reporting Act (FCRA, 15 U.S.C. §1681 et seq.), the Fair Housing Act (42 U.S.C. §3604), and Nevada law (NRS Chapter 118A).

Important Disclosures Before Completing
- Nevada law permits landlords to charge a reasonable screening or application fee not exceeding the landlord's actual out-of-pocket costs of obtaining the consumer report or background check. The fee amount is disclosed above.
- A written receipt will be provided for any application or screening fee collected.
- A consumer report (credit report, background check, eviction history, etc.) may be obtained.
- If tenancy is denied based in whole or in part on information in a consumer report, the applicant may request a free copy of the screening report used.
- This application does not create a tenancy or guarantee approval. All decisions are based on objective, consistently applied screening criteria.
- Fair housing laws prohibit discrimination based on race, color, religion, sex, familial status, national origin, or disability.

All user-supplied values are `[[Token Name]]` placeholders.

1. Applicant personal / contact information and residency history

Applicant Full Legal Name: [[Applicant Full Name]]
Date of Birth: [[Date of Birth]]
Social Security Number (last 4 for verification): [[SSN Last 4]] (full SSN required on consent page)
Driver's License / Government ID State & Number: [[DL State and Number]]
Current Phone: [[Applicant Phone Number]]
Email Address: [[Applicant Email Address]]
Current Address: [[Current Street Address, City, State, ZIP]]
How long at current address: [[Duration at Current Address]]

Previous Addresses (past 3 years, attach additional sheet if needed)

Emergency Contact
- Name: [[Emergency Contact Full Name]]
- Relationship: [[Relationship]]
- Phone: [[Emergency Contact Phone]]

Other Occupants (all adults and children who will reside in the unit)
[[List full names, ages, and relationship for all proposed occupants or state "None other than applicant(s)"]]

2. Government ID / SSN and consent / authorization for background and credit check (FCRA disclosure)

Authorization and Release for Consumer Reports

I authorize [[Landlord or Management Company Name]] and its screening agents to obtain consumer reports, including but not limited to credit reports, criminal background checks, eviction history, employment and income verification, and rental history, for the purpose of evaluating this rental application.

I understand that:
- This is a consumer report as defined by the Fair Credit Reporting Act (15 U.S.C. §1681).
- If any adverse action (denial, conditional approval, or increased deposit) is taken based in whole or in part on information in a consumer report, I will be provided a copy of the report and a summary of my rights under FCRA.
- I may obtain a free copy of my credit report annually at www.annualcreditreport.com.
- I may dispute inaccurate information directly with the consumer reporting agency.
- Upon request after an adverse decision, I am entitled to a copy of the screening report used.

Full Legal Name (as appears on ID): [[Applicant Full Name]]
SSN: [[Full Social Security Number, will be redacted after screening]]
Date of Birth: [[Date of Birth]]
Current Address for Report: [[Current Address]]

Applicant Signature / Electronic Signature Authorization

By signing below (or checking the electronic consent box), I certify that all information provided is true and complete, and I authorize the procurement of consumer reports as described.

Applicant Signature: _______________________________ Date: [[Application Date]]

Printed Name: [[Applicant Full Name]]

Co-Applicant (if applicable)
Co-Applicant Signature: _______________________________ Date: [[Application Date]]
Printed Name: [[Co-Applicant Full Name]]

3. Employment and income verification (income multiple: [[Income Multiple]]× monthly rent)

Current Employment
- Employer Name: [[Current Employer Name]]
- Position / Title: [[Job Title]]
- Supervisor / HR Contact: [[Supervisor Name and Phone]]
- Employer Address: [[Employer Address]]
- Dates of Employment: [[Start Date]] to Present
- Monthly Gross Income: [[Monthly Gross Income]]
- Other Income Source 1: [[Other Income Source and Amount, e.g. "Social Security $1,200/mo"]]
- Other Income Source 2: [[Additional Income or "None"]]

Additional Employment (if any)
- Employer Name: [[Second Employer Name or "N/A"]]
- Position / Title: [[Second Job Title]]
- Monthly Gross Income: [[Second Monthly Gross Income]]

Bank / Financial References
- Bank Name: [[Bank Name]]
- Account Type: [[Checking / Savings]]
- Branch / Contact: [[Bank Contact or Branch]]

4. Rental history and landlord references

Current Landlord / Property Manager
- Name: [[Current Landlord Name]]
- Phone: [[Current Landlord Phone]]
- Address: [[Current Landlord Address]]
- Dates of Tenancy: [[Current Tenancy Start]] to Present
- Monthly Rent Paid: [[Current Monthly Rent]]

Previous Landlord / Property Manager (most recent prior)
- Name: [[Previous Landlord 1 Name]]
- Phone: [[Previous Landlord 1 Phone]]
- Address: [[Previous Landlord 1 Address]]
- Dates of Tenancy: [[Previous Tenancy 1 Start]] to [[Previous Tenancy 1 End]]
- Monthly Rent Paid: [[Previous Monthly Rent 1]]
- Reason for Leaving: [[Previous Reason for Leaving 1]]

Additional Prior Rental History (if needed)
- Name: [[Previous Landlord 2 Name]]
- Phone: [[Previous Landlord 2 Phone]]
- Dates: [[Previous Tenancy 2 Start]] to [[Previous Tenancy 2 End]]

5. Application and screening fee disclosure (Nevada)

Nevada does not impose a statutory maximum on application or screening fees. The fee charged must be reasonable and limited to the landlord's actual out-of-pocket costs for obtaining the consumer report(s) or background screening.

Application / Screening Fee Amount: $[[Application Fee Amount]]
Purpose: To cover the actual costs of obtaining credit report, background check, eviction history, and related screening services.
Refund Policy: The fee is non-refundable regardless of the approval decision.
Receipt: A written receipt for this fee will be provided upon collection.

If the applicant is denied tenancy based on the screening report, the applicant may request in writing a copy of the report used within 60 days of the adverse action. The landlord will provide the name and address of the consumer reporting agency and a copy of the report.

6. Screening criteria (objective, consistently applied, fair-housing compliant)

The following objective criteria will be used to evaluate all applications. These criteria are applied uniformly and are designed to avoid disparate impact in accordance with HUD guidance on criminal background screening and the Fair Housing Act.

1. Income requirement: Combined gross monthly household income must equal or exceed [[Income Multiple, typically 3]] times the monthly rent (or other stated multiple).

2. Credit history: Minimum credit score of [[Minimum Credit Score, e.g. 580]] or equivalent risk assessment. Recent bankruptcies, collections, or judgments related to housing may be considered.

3. Rental history: No evictions within the past [[Eviction Lookback Years, e.g. 5]] years. No history of lease violations resulting in termination within the past [[Violation Lookback, e.g. 3]] years.

4. Criminal background: Convictions for certain offenses (violent crimes, sex offenses, drug trafficking within lookback period) may result in denial. Arrests without conviction and expunged records are not considered. Individualized assessment will be provided where required.

5. Employment stability: At least [[Employment Stability Months, e.g. 6]] months of continuous employment or verifiable income source.

6. Other: No false information provided on the application; ability to provide positive references from prior landlords.

Applicants who do not meet one or more criteria may still be considered with additional documentation, guarantor, or higher deposit where permitted by law.

7. Fair-housing nondiscrimination notice (federal FHA + Nevada)

[[Landlord or Management Company Name]] is an equal housing opportunity provider. We comply with the federal Fair Housing Act and Nevada law (NRS Chapter 118). We do not discriminate on the basis of race, color, religion, sex, familial status, national origin, disability, sexual orientation, gender identity, or any other protected class under applicable law.

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 Nevada Equal Rights Commission.

8. Pets / occupants / vehicles / additional information

Pets: [[Pet Policy, e.g. "No pets without prior written consent. Additional pet deposit or rent may apply for approved pets."]]

Vehicles: Number of vehicles: [[Number of Vehicles]]. Parking: [[Assigned or Street Parking Details]].

Additional Requests or Notes: [[Any special requests or additional information applicant wishes to provide]]

9. Signature and authorization

I certify under penalty of perjury that the information provided in this application is true, complete, and accurate to the best of my knowledge. I authorize verification of all information, including obtaining consumer reports as described above. I understand that any false statement may result in denial of the application or termination of any tenancy granted.

Applicant

Signature: ___________________________________________ Date: [[Application Date]]

Printed Name: [[Applicant Full Name]]

Co-Applicant (if applicable)

Signature: ___________________________________________ Date: [[Application Date]]

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

Landlord / Agent Acknowledgment of Receipt

Received by: [[Landlord or Agent Name]] Date: [[Receipt Date]], -

*Sample template for Nevada, not legal advice. Statutory provisions cited are current as of 2026-06; verify against the current Nevada Revised Statutes (NRS Chapter 118A) and any local ordinances before use. Application fees must not exceed actual out-of-pocket screening costs. Consult NRS 118A.306 and 118A.250 for receipt requirements.*