Oregon Rental Application

This Rental Application is for use in screening prospective tenants for residential rental property in Oregon. It complies with the Oregon Residential Landlord and Tenant Act (ORS Chapter 90) and related laws, including:

• ORS 90.295, limits on application screening fees (actual costs only)
• Oregon Fair Housing Act (ORS 659A.421), prohibited discrimination
• Federal Fair Credit Reporting Act (FCRA), adverse action notices when consumer reports are used
• Source-of-income protections (state and local, including Portland)

All user-entered data fields use `[[Token Name]]` placeholders. Fixed legal notices, disclosures, and consent language are written in full.

1. Property and tenancy information

Property Address: [[Full Street Address]], [[City]], OR [[ZIP Code]]

Unit (if applicable): [[Unit / Apt Number]]

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

Contact for Application: [[Phone]] | [[Email]] | [[Mailing Address]]

Monthly Rent: [[Monthly Rent Amount]]
Security Deposit: [[Security Deposit Amount]] (subject to ORS 90.300 limits and accounting rules)
Other Recurring Charges: [[Pet Rent / Parking / Other: [[Amount(s)]]]]

Lease Type Desired: [[Fixed Term [[Length, e.g. 12 months]] / Month-to-Month]]

Move-in Date Desired: [[Desired Move-in Date]]

Application Fee (if charged): [[Application / Screening Fee Amount]], limited to landlord's actual screening costs per ORS 90.295. An itemized receipt will be provided upon request or if the applicant is denied.

2. Applicant information

Full Legal Name: [[Applicant Full Legal Name]]
Date of Birth: [[DOB]]
Social Security Number: [[SSN (last 4 or full as required for screening)]]
Driver's License / State ID: [[State and Number]]

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

Current Address: [[Street, City, State, ZIP]]
How Long at Current Address: [[Months / Years]]
Landlord / Manager Name & Phone at Current: [[Name and Phone]]

Previous Address (if < 2 years at current): [[Street, City, State, ZIP]]
How Long: [[Months / Years]]
Landlord / Manager Name & Phone: [[Name and Phone]]

Other Occupants (all adults and minors): [[List full names, ages, relationship]]

3. Employment and income information

Current Employer: [[Employer Name]]
Position / Title: [[Job Title]]
Supervisor / HR Contact: [[Name and Phone]]
Employment Start Date: [[Start Date]]
Monthly Gross Income: [[Gross Monthly Income Amount]]

Other Income Sources (e.g. retirement, disability, child support, housing assistance): [[Describe source and amount or "None"]]

Co-Applicant / Additional Household Income: [[Name]], [[Income Amount and Source]]

Source of Income Protections: Landlord will not discriminate on the basis of lawful source of income, including but not limited to Section 8 / housing choice vouchers, where protected by state law or local ordinance (e.g., Portland).

4. Rental / residency history

Prior Landlord References (last 3 years preferred):

1. Landlord Name: [[Name]] | Phone: [[Phone]] | Address: [[Address]] | Dates: [[Dates]] | Reason for Leaving: [[Reason]]

2. Landlord Name: [[Name]] | Phone: [[Phone]] | Address: [[Address]] | Dates: [[Dates]] | Reason for Leaving: [[Reason]]

Have you ever been evicted or had an unlawful detainer filed against you? [[No / Yes, explain dates, jurisdiction, outcome]]

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

5. Credit, background, and consumer report authorization (FCRA disclosure)

By signing below, Applicant authorizes the Landlord or its screening agent to obtain and use consumer reports (credit report, criminal background, eviction history, etc.) for the purpose of evaluating this rental application.

FCRA Disclosure: If a consumer report is used in whole or in part in making an adverse decision (denial, higher deposit, or other adverse action), Landlord will provide Applicant with:

• A copy of the consumer report
• A written description of Applicant's rights under the FCRA
• Notice of the adverse action and contact information for the consumer reporting agency

Landlord will not use reports in violation of the Fair Credit Reporting Act or applicable state law.

Consent to Verify Information: Applicant authorizes verification of all information provided, including contacting employers, landlords, references, and obtaining public records.

6. Application screening fee and payment

Screening Fee Amount Charged: [[Fee Amount]] (not to exceed Landlord's actual out-of-pocket costs for obtaining the consumer report(s) and related screening).

Payment Method: [[Cash / Check / Money Order / Online Portal / Other]]

Landlord will provide an itemized receipt of actual screening costs upon request. If Applicant is denied, Landlord will provide an itemized statement of the screening costs incurred as required by ORS 90.295.

Fee Refund Policy: The screening fee is non-refundable once screening has been initiated, except as required by law or Landlord policy.

7. Fair housing and nondiscrimination notice

Landlord complies with the federal Fair Housing Act and Oregon law (ORS 659A.421). It is unlawful to discriminate in the rental of housing on the basis of:

Race, color, religion, sex, national origin, familial status, disability, marital status, sexual orientation, gender identity, source of income (in applicable jurisdictions), or any other protected class under federal, state, or local law.

Reasonable Accommodations / Modifications: Landlord will consider requests for reasonable accommodations and modifications for persons with disabilities in accordance with the law.

Any applicant who believes they have been discriminated against may contact the Oregon Bureau of Labor and Industries (BOLI), HUD, or legal aid.

8. Applicant declarations and certifications

I certify that all information provided in this application is true, complete, and accurate to the best of my knowledge. I understand that:

• Providing false, incomplete, or misleading information may result in denial of the application or termination of any tenancy created.
• Landlord may verify any information provided.
• This application does not create a tenancy or guarantee approval.
• Approval is subject to satisfactory screening, availability, and execution of a rental agreement.

Applicant Signature: _______________________________ Date: [[Date]]

Printed Name: [[Applicant Full Legal Name]]

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

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

9. Landlord use only, screening decision record

Application Received Date: [[Date]]

Screening Completed Date: [[Date]]

Screening Reports Obtained: [[Credit / Criminal / Eviction / Other]]

Decision: [[Approved / Approved with conditions (higher deposit / guarantor / etc.) / Denied]]

If Denied or Adverse Action Taken:

• Primary reason(s): [[Insufficient income / Poor credit / Negative rental history / Criminal background / Incomplete application / Other]]

• Consumer report used? [[Yes / No]], If yes, FCRA adverse action notice and copy of report provided on: [[Date]]

Itemized Screening Costs (if fee charged): [[List actual costs, e.g. "Credit report $X, Background $Y, Total $Z"]]

Receipt / Statement Provided to Applicant: [[Yes, date [[Date]] / Method [[Email / Mail / In person]]]]

Approved Unit / Rent / Deposit Terms: [[Describe or "N/A"]]

Notes: [[Any additional notes or conditions]]

Landlord / Agent Signature: _______________________________ Date: [[Date]]

Printed Name / Title: [[Landlord or Screening Agent Name and Title]]

10. Attachments and supporting documents checklist

Applicant to provide copies of (as requested):

• Government-issued photo ID
• Recent pay stubs (last 2, 3 months) or proof of income
• Bank statements (if requested)
• Prior landlord references / contact info
• Proof of legal right to be in the U.S. (if required by law for verification)
• Pet information / vaccination records (if applicable)
• Other: [[List]]

11. Record retention

Landlord will retain application records, screening reports (subject to FCRA disposal rules), and decision documentation for [[3 / 4]] years or as required by applicable law, whichever is longer. Denied applicants will receive required adverse action notices and report copies where consumer reports were used.

12. Statutory references (Oregon, as of June 2026)

*Template, not professional legal advice. This application form and screening process must be used in compliance with current Oregon and federal law. Application fees must not exceed actual screening costs. Provide required disclosures and adverse action notices when using consumer reports. Local ordinances may impose additional rules (e.g., Portland source-of-income protections). Consult qualified counsel or a property management professional familiar with Oregon residential rental law before use. Verify all requirements as of the date of the application. Requirements current as of June 2026.*