North Dakota Rental Application

Property Address: [[Property Full Street Address]], [[City]], North Dakota [[ZIP Code]]

Monthly Rent: $[[Monthly Rent Amount]]

Security Deposit: $[[Security Deposit Amount]] (capped at one month's rent for standard tenancies per NDCC § 47-16-07.1, subject to statutory exceptions)

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

Application Date: [[Application Date]]

Application / Screening Fee: $[[Application Fee Amount]] (non-refundable; no statutory cap under North Dakota law)

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

Contact for Application Questions: [[Landlord Phone]] | [[Landlord Email]]

This Rental Application is submitted to evaluate the applicant's suitability for tenancy at the above property. All information will be used solely for screening in compliance with the federal Fair Credit Reporting Act (FCRA, 15 U.S.C. § 1681 et seq.), the Fair Housing Act (42 U.S.C. § 3604), and North Dakota law (NDCC Chapter 47-16).

Important Disclosures

• North Dakota does not impose a statutory cap on application or screening fees. The fee disclosed above is non-refundable regardless of the approval decision.

• A consumer report (credit, background, eviction history, criminal records, etc.) may be obtained and used in the screening process.

• Under the FCRA, if an adverse action (denial, higher deposit, or other unfavorable term) is taken based in whole or in part on a consumer report, the applicant will receive an adverse action notice with a copy of the report and a summary of rights.

• This application does not create a tenancy, guarantee approval, or obligate the landlord to rent to the applicant. Decisions are based on objective, consistently applied criteria that comply with fair housing laws.

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

1. Applicant Personal and Contact Information

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

Date of Birth: [[Date of Birth]]

Social Security Number (last 4 digits for initial verification): [[SSN Last 4]] (full SSN will be required upon conditional approval or for consumer reporting agency)

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

Current Phone Number: [[Applicant Primary Phone]]

Email Address: [[Applicant Email]]

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

How long at current address: [[Years / Months]]

Reason for moving: [[Reason for Relocation]]

Marital / Household Status (optional, for reference only): [[Single / Married / Domestic Partner / Other]]

2. Additional Occupants and Household Composition

List all persons who will reside in the Premises (including children):

3. Residency History (last 3 years, attach additional pages if needed)

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

Current Landlord Phone: [[Current Landlord Phone]]

Current Landlord Email: [[Current Landlord Email]]

Monthly Rent at Current Address: $[[Current Monthly Rent]]

Dates of Residency: [[From Date]] to [[To Date or Present]]

Previous Landlord / Property Manager Name: [[Previous Landlord Name]]

Previous Landlord Phone: [[Previous Landlord Phone]]

Dates of Residency: [[From Date]] to [[To Date]]

Monthly Rent: $[[Previous Rent]]

Reason for Leaving: [[Reason]]

Any evictions, unlawful detainers, or lease terminations for cause in the past 7 years? [[Yes, explain / No]]

If yes, provide details: [[Explanation of Prior Eviction or Termination]]

4. Employment and Income Information

Current Employer: [[Current Employer / Company Name]]

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

Position / Title: [[Job Title]]

Supervisor / HR Contact: [[Supervisor Name]] Phone: [[Supervisor Phone]]

Dates of Employment: [[Start Date]] to [[Present or End Date]]

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

Other Income Sources (alimony, child support, investments, etc., disclose only if desired for qualification): [[Describe Source and Amount or "None"]]

Previous Employer (if current employment < 2 years): [[Previous Employer Name]] Phone: [[Phone]]

Dates: [[Dates]] Monthly Gross: $[[Amount]]

5. Financial and Credit Information

Banking Institution: [[Bank Name]]

Approximate Checking / Savings Balances (optional but helpful): [[Balances or "Decline to state"]]

Credit Score Range (self-reported, optional): [[Range or "Decline to provide"]]

Have you ever filed for bankruptcy? [[Yes, chapter and discharge date / No]]

Any outstanding judgments, liens, or collections related to housing or utilities? [[Yes, describe / No]]

6. Vehicles and Parking

Vehicles to be parked at the property:

Parking needs: [[Number of spaces requested]]

7. Pets and Assistance Animals

Pets (dogs, cats, other): [[Number and Type, e.g., "One 25-lb dog named Max" or "None"]]

Pet deposit or fee (if applicable): $[[Pet Deposit Amount]]

Assistance or service animals (not subject to pet policies): [[Yes, describe type and documentation available / No]]

8. Emergency Contact and Personal References

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

Personal Reference 1: [[Name]] Phone: [[Phone]] Relationship: [[Relationship]]

Personal Reference 2: [[Name]] Phone: [[Phone]] Relationship: [[Relationship]]

9. Applicant Authorization and Consent

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

I authorize the Landlord, its agents, and any consumer reporting agency to:

1. Verify any information provided, including employment, income, residency history, and references.

2. Obtain one or more consumer reports (credit report, criminal background, eviction history, etc.) for tenant screening purposes.

3. Contact current and prior landlords, employers, and references.

I understand that this authorization is valid for the duration of the application process and any resulting tenancy.

Applicant Signature: _______________________________________________ Date: [[Application Date]]

Printed Name: [[Applicant Full Legal Name]]

Co-Applicant / Additional Adult Signature (if applicable): _______________________________________________ Date: [[Date]]

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

10. FCRA Consumer Report Disclosure and Summary of Rights

Important Notice to Applicant (FCRA 15 U.S.C. § 1681b and § 1681m)

A consumer report may be obtained in connection with this application. The report may contain information about your creditworthiness, credit standing, credit capacity, character, general reputation, personal characteristics, and mode of living.

If the Landlord takes an adverse action (denial of tenancy, requirement of higher deposit or co-signer, or other unfavorable action) based in whole or in part on information in a consumer report, you will be provided:

• A notice of the adverse action.

• The name, address, and telephone number of the consumer reporting agency that supplied the report.

• A copy of the consumer report (free if requested within 60 days).

• A copy of the FTC's "Summary of Your Rights Under the Fair Credit Reporting Act."

You have the right to dispute any inaccurate information directly with the consumer reporting agency.

Landlord will provide the required adverse action notice and copy of the report if applicable.

11. Fair Housing and Non-Discrimination

This property is offered in compliance with the federal Fair Housing Act and North Dakota fair housing laws. We do not discriminate on the basis of race, color, religion, sex, national origin, familial status, disability, or any other protected class under applicable law.

Screening criteria are applied consistently to all applicants.

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

Application Received Date: [[Date]]

Fee Received: $[[Amount]] Method: [[Cash / Check / Card / Other]]

Consumer Report Ordered From: [[Agency Name]] Date: [[Date]]

Report Reference / File #: [[Reference Number]]

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

Conditions or Reason for Denial (if applicable): [[Brief objective reason or "N/A"]]

Adverse Action Notice Provided (if required): [[Yes, date and method / N/A]]

Notes: [[Internal notes]]

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

End of North Dakota Rental Application

Governing Authority: NDCC Chapter 47-16 (Landlord and Tenant); federal FCRA (15 U.S.C. §1681 et seq.); Fair Housing Act (42 U.S.C. §3604). North Dakota does not cap application fees. Landlords may obtain credit and background checks with consent. Adverse action notice required under FCRA when consumer report is used for denial or other adverse decision. This is a template. Verify current requirements and use consistent, non-discriminatory criteria. Not legal advice. Current as of June 2026.

> ⚠️ Template example, not professional (legal/financial/medical) advice. Figures and clauses must be verified for the applicable jurisdiction and kept current. All variable values use [[Token Name]] placeholders.