North Carolina Rental Application

Property Address: [[Property Street Address, Unit if any]], [[City]], North Carolina [[ZIP Code]]

Requested Monthly Rent: $[[Monthly Rent Amount]]

Lease Term Requested: [[Lease Term in Months or "Month-to-Month"]]

Move-In Date Requested: [[Requested Move-In Date]]

Date of Application: [[Application Date]]

Landlord / Property Manager: [[Landlord or Management Company Full Legal Name]], -

IMPORTANT, NORTH CAROLINA LAW AND FEDERAL COMPLIANCE NOTICE

Under N.C.G.S. § 42-1 et seq. (North Carolina Landlord-Tenant Act), landlords may charge reasonable application and screening fees to cover the actual costs of processing the application, including credit and background checks. There is no statewide statutory cap on application fees. However, any fee must be reasonable and related to actual screening costs incurred.

North Carolina does not have statewide rent control. Landlords may set rents and screening standards subject only to the federal Fair Housing Act and state fair housing laws. Discrimination on the basis of race, color, religion, sex, national origin, disability, or familial status is prohibited.

Criminal background and credit checks are permitted when conducted consistently with the Fair Credit Reporting Act (FCRA). If adverse action is taken based in whole or in part on a consumer report, the applicant must receive an adverse action notice with the name and address of the reporting agency and a summary of rights.

A returned check fee is capped at the greater of $35 or five percent (5%) of the check amount under applicable North Carolina law.

All information collected will be used solely for evaluating this rental application and will be handled in compliance with FCRA and applicable privacy requirements., -

1. Applicant Information

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

Date of Birth: [[Date of Birth]] | Social Security Number (last 4): [[XXX-XX-]][[SSN Last 4]]

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

Current Phone: [[Phone Number]] | Email: [[Email Address]]

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

Length of Time at Current Address: [[Years / Months]] | Reason for Leaving: [[Reason for Moving]]

Current Landlord or Property Manager: [[Current Landlord or Manager Name]]

Current Landlord Phone / Email: [[Current Landlord Phone or Email]]

Current Monthly Rent or Housing Cost: $[[Current Monthly Housing Payment]], -

2. Co-Applicants and Additional Occupants

List every adult (age 18 or older) who will reside in the Premises.

1. [[Co-Applicant 1 Full Legal Name]], Relationship to Primary: [[Relationship]], DOB: [[Date of Birth]]

2. [[Co-Applicant 2 Full Legal Name]], Relationship to Primary: [[Relationship]], DOB: [[Date of Birth]]

Minor children (under 18) who will reside at the Premises: [[Number, ages, and names or "None"]]

Will any occupant require a reasonable accommodation due to a disability? [[Yes / No, if Yes, describe the accommodation needed without providing medical diagnosis: [[Accommodation Description]]]], -

3. Employment and Income Verification

Current Employer: [[Employer or Company Name]]

Position / Title: [[Job Title]]

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

Length of Current Employment: [[Years / Months]]

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

Other Sources of Income (optional but helpful): [[Alimony, child support, disability, investments, side income, or "None"]]

Previous Employer (if current employment less than 2 years): [[Previous Employer Name]], [[Dates Employed]], Gross Monthly: $[[Previous Gross Monthly]]

Co-Applicant Employment Summary (if applicable): [[Co-Applicant Employer, Title, Gross Monthly Income, or "N/A"]]

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

4. Rental and Housing History (Last Three Years)

Prior Address 1: [[Street, City, State, ZIP]]

Dates Occupied: [[From Date]] to [[To Date]]

Landlord or Manager Name: [[Prior Landlord Name]]

Landlord Phone: [[Prior Landlord Phone]]

Monthly Rent Paid: $[[Prior Monthly Rent]]

Reason for Leaving: [[Reason]]

Prior Address 2: [[Street, City, State, ZIP]]

Dates Occupied: [[From Date]] to [[To Date]]

Landlord or Manager Name: [[Prior Landlord Name]]

Landlord Phone: [[Prior Landlord Phone]]

Monthly Rent Paid: $[[Prior Monthly Rent]]

Reason for Leaving: [[Reason]]

Have you ever been evicted or had an eviction action filed against you? [[Yes / No, if Yes, explain fully including dates and outcome: [[Explanation]]]]

Have you ever been a party to a landlord-tenant lawsuit or dispute? [[Yes / No, if Yes, explain: [[Explanation]]]], -

5. Credit, Criminal Background, and Consumer Report Authorization (FCRA)

Consumer Report Authorization and Disclosure

I/we authorize [[Landlord or Property Management Company Full Legal Name]] ("Landlord") and its authorized agents to obtain one or more consumer reports (including credit reports, criminal background checks, eviction history, and other permissible reports under the Fair Credit Reporting Act) about me/us for the purpose of evaluating this rental application.

This authorization is made pursuant to the federal Fair Credit Reporting Act, 15 U.S.C. § 1681 et seq.

I/we understand and agree that:

1. A consumer report may be obtained and used in the rental decision.

2. If the application is denied or other adverse action is taken based in whole or in part on information in a consumer report, I/we will receive an "adverse action" notice as required by FCRA containing the name, address, and telephone number of the consumer reporting agency and a statement of my/our rights.

3. I/we have the right to obtain a free copy of the consumer report if I/we request it within sixty (60) days of receiving an adverse action notice.

4. I/we have the right to dispute directly with the consumer reporting agency the accuracy or completeness of any information in the report.

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

Co-Applicant Signature for Authorization: _______________________________________________ Date: [[Date]], -

6. Application and Screening Fee

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

This fee is charged to cover the actual costs of processing the application and obtaining consumer reports. The fee is [[non-refundable / partially refundable if no report is ordered]].

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

Date Fee Received: [[Date]], -

7. Pets, Occupants, Vehicles, and Other Occupants

Pets: [[No pets / One dog / One cat / Other, describe fully including breed, weight, age, service or emotional support animal status: [[Pet Details]]]]

Pet Deposit or Pet Rent (if any): $[[Pet Deposit or Monthly Pet Rent Amount or "N/A"]]

Vehicles to be parked on property: [[Number and type: [[e.g., 1 sedan, 1 SUV]], License plates if known: [[Plates or "N/A"]]]]

Smoking Policy Preference: [[Non-smoking household / Smoker, describe: [[Details]]]]

Additional Occupants or Guests Expected Regularly: [[Description or "None"]], -

8. References

Personal Reference 1: [[Full Name]], Relationship: [[Relationship]], Phone: [[Phone]], Email: [[Email]]

Personal Reference 2: [[Full Name]], Relationship: [[Relationship]], Phone: [[Phone]], Email: [[Email]]

Professional or Employment Reference: [[Full Name]], Title: [[Title]], Phone: [[Phone]], Email: [[Email]], -

9. Screening Criteria Acknowledgment

Landlord uses objective, consistently applied screening criteria. Typical factors may include:

1. Income at least [[X]] times the monthly rent (or other stated multiple).

2. Credit history and score thresholds.

3. Criminal background check results (subject to individualized assessment per fair housing guidance).

4. Prior rental history and references.

5. Eviction history within a reasonable look-back period.

The specific criteria applied to this application are available upon request after submission. All applicants are evaluated consistently in compliance with the federal Fair Housing Act., -

10. Fair Housing and Nondiscrimination Notice

Landlord complies with the federal Fair Housing Act and North Carolina fair housing laws. We do not discriminate on the basis of race, color, religion, sex, national origin, disability, familial status, or any other protected class.

If you believe you have been discriminated against, you may contact the U.S. Department of Housing and Urban Development (HUD) or the North Carolina Human Relations Commission., -

11. Applicant Certification and Signature

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 material omission may result in denial of the application or termination of any resulting tenancy. I/we authorize verification of all information provided, including contacting current and prior landlords, employers, and references, and obtaining consumer reports as described above.

Primary Applicant Signature: _______________________________________________ Date: [[Date]]

Printed Name: [[Applicant Full Legal Name]]

Co-Applicant Signature: _______________________________________________ Date: [[Date]]

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

12. Landlord / Agent Use Only

Application Received Date: [[Date]]

Fee Received: $[[Amount]] Method: [[Method]]

Credit / Background Report Ordered Date: [[Date]]

Report Provider: [[Agency Name]]

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

Adverse Action Notice Sent (if applicable): [[Date / N/A]]

Lease Prepared Date: [[Date]]

Notes: [[Internal notes only]]

Processed By: [[Agent or Staff Name]] Date: [[Date]], -

End of North Carolina Rental Application

Sources: N.C.G.S. § 42-1 et seq.; 15 U.S.C. § 1681 et seq. (FCRA); 42 U.S.C. § 3601 et seq. (Fair Housing Act). Returned check fees per N.C. law. This template is provided for reference and is not legal advice. Verify current requirements before use. As of June 2026.