Utah Residential Rental Application

This Utah Residential Rental Application is designed for use in residential lease transactions in the State of Utah. It complies with the Utah Fit Premises Act (Utah Code Ann. § 57-22-1 et seq.) and incorporates federal Fair Credit Reporting Act (FCRA) requirements for background and credit screening. There is no statutory cap on screening or application fees in Utah; however, the fee amount and its non-refundable nature must be clearly disclosed.

Landlords must apply consistent, objective screening criteria and comply with the federal Fair Housing Act as well as the Utah Fair Housing Act, which provides protections including for source of income. Adverse action notices under FCRA are required if an application is denied or other adverse action is taken based on a consumer report.

Applicants are advised that providing false information may result in denial or termination of tenancy., -

Section 1, Property and Landlord Information

Date of Application: [[Application Date]]

Property Address: [[Street Address]], [[City]], Utah [[ZIP Code]]

Unit / Apt #: [[Unit Number or N/A]]

Monthly Rent: $[[Monthly Rent Amount]]

Security Deposit: $[[Security Deposit Amount]]

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

Lease Term: [[Month-to-Month / 6-Month / 12-Month / Other: [[Specify]]]]

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

Phone: [[Landlord Phone]] Email: [[Landlord Email]]

Application / Screening Fee: $[[Fee Amount]] (non-refundable; covers actual costs of processing including credit/background checks), -

Section 2, Applicant Information

*Each adult applicant (18+) who will reside in the unit must submit a separate application. Co-applicants may be listed on a joint application where permitted by the landlord's policy.*

Full Legal Name: [[Full Legal Name]]

Date of Birth: [[MM/DD/YYYY]]

Social Security Number (last 4 for verification): [[Last 4 SSN]] (Full SSN may be collected securely for screening)

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

Phone (Primary): [[Primary Phone]] Alternate: [[Alternate Phone]]

Email: [[Email Address]]

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

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

Reason for leaving: [[Reason]]

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

Section 3, Residency History (Last 3 Years or Last 2 Residences)

Provide complete information for current and previous residences. Landlord may contact prior landlords.

Current Residence

Previous Residence #1

Previous Residence #2 (if applicable)

Section 4, Employment and Income Verification

Current Employer: [[Employer Name]]

Position / Title: [[Job Title]]

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

Employment Start Date: [[Date]]

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

Other Income Sources (alimony, child support, investments, etc., optional but may strengthen application): [[Describe source and amount]]

Previous Employer (if current employment < 1 year): [[Name]] Dates: [[Dates]] Phone: [[Phone]]

Self-employed applicants: Provide business name, nature of business, and most recent tax return summary or bank statements as requested., -

Section 5, Screening, Credit, and Background Check Consent (FCRA Compliant)

Screening Fee Acknowledgment: I understand that the non-refundable screening fee of $[[Fee Amount]] is charged to cover the actual costs of obtaining consumer reports, credit reports, criminal background checks, and related verification services. This fee is not a deposit and will not be applied to rent or security deposit.

I authorize the Landlord / Property Manager and its screening agents to obtain consumer reports, credit reports, criminal background information, eviction history, and other relevant information about me from third-party reporting agencies for the purpose of evaluating this rental application. This authorization is valid for the duration of the application process and any permitted re-screening during tenancy.

I understand that if the Landlord takes adverse action (denial, requirement of co-signer/guarantor, higher deposit, or other) based in whole or in part on information in a consumer report, the Landlord will provide me with:
- A notice of the adverse action
- The name, address, and phone number of the consumer reporting agency that furnished the report
- A statement that the reporting agency did not make the decision and cannot explain why the decision was made
- Notice of my right to obtain a free copy of the report and to dispute its accuracy

Applicant Signature for Consent: [[Signature / Electronic Acknowledgment]] Date: [[Date]], -

Section 6, Screening Criteria (Objective Standards)

The following minimum standards are applied uniformly. Meeting these criteria does not guarantee approval; other factors (complete application, references, criminal history details, etc.) are also considered.

• Income: Combined gross monthly household income should be at least [[2.5x / 3x]] the monthly rent (or other objective multiple disclosed here: [[Specify multiple or formula]]).
• Credit: Minimum credit score of approximately [[Score threshold, e.g. 620]] or acceptable alternative history. Bankruptcies, collections, and judgments will be evaluated on a case-by-case basis with mitigating factors considered.
• Rental History: No evictions within the last [[X years]]; positive references from prior landlords preferred. Outstanding balances to prior landlords may result in denial.
• Criminal History: Evaluated consistent with HUD guidance. Convictions for violent crimes, sex offenses, or crimes directly related to property damage or drug manufacturing/distribution within the last [[X years]] will generally result in denial. Arrests without conviction are not considered.
• Other: Accurate and complete application; no false statements.

Applicant may provide additional explanation or mitigating information here: [[Optional explanation]], -

Section 7, Fair Housing Notice and Utah Protections

Equal Housing Opportunity. We comply with the federal Fair Housing Act and the Utah Fair Housing Act. It is unlawful to discriminate in the rental of housing on the basis of race, color, religion, sex, national origin, familial status, disability, source of income, or other protected classes under applicable law.

We apply objective, uniformly applied screening criteria. If you believe you have been discriminated against, you may contact the Utah Anti-Discrimination and Labor Division or the U.S. Department of Housing and Urban Development (HUD).

Source of Income: Utah law prohibits discrimination based on lawful source of income (including housing choice vouchers / Section 8 where accepted per policy). We do not apply different standards to applicants using rental assistance., -

Section 8, Occupants, Pets, and Vehicles

All Occupants (including children): [[List all persons who will reside, with ages if minors]]

Pets: [[None / List: Type, Breed, Weight, Age, Number]] Service or assistance animals: [[Describe if applicable, not subject to pet fees per law]]

Vehicles: Number: [[#]] Types: [[Car / Truck / Motorcycle etc.]] License plates will be provided at move-in.

Smoking Policy: [[Non-smoking / Designated areas only / Other]], -

Section 9, Additional Questions and Authorizations

Have you ever been evicted or asked to vacate? [[Yes / No]], If yes: [[Explain]]

Have you ever been convicted of a felony? [[Yes / No]], If yes: [[Year, nature, jurisdiction, current status]]

Do you have renter's insurance or intend to obtain it? [[Yes / Planning to obtain]]

Any other information you wish to provide to support your application: [[Details]], -

Applicant Certification and Signature

I certify that all information provided in this application is true, complete, and accurate to the best of my knowledge. I understand that any false statement or omission may result in denial of this application or termination of any lease entered into. I authorize verification of all information and release of information by prior landlords, employers, and reporting agencies.

Applicant Signature: _______________________________________________ Date: [[Date]]

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

Landlord / Agent Use Only (Internal)

Application received: [[Date/Time]] Fee paid: [[Yes / No, Amount $[[ ]]] Method: [[ ]]

Screening ordered: [[Date]] Reports received: [[Date]]

Decision: [[Approved / Denied / Approved with conditions: [[Guarantor / Higher deposit / Other]]]] Date: [[ ]]

Adverse action notice sent (if applicable): [[Date]] Copy of report provided: [[Yes / N/A]], -

Sources and Notes (as of June 2026)

• Utah Code Ann. § 57-22-1 et seq. (Fit Premises Act).
• Utah Fair Housing Act (Utah Code Ann. § 57-21-1 et seq.) and source-of-income protections.
• Federal Fair Credit Reporting Act (15 U.S.C. § 1681 et seq.) adverse action and disclosure requirements.
• HUD guidance on criminal background screening in housing (2016 and subsequent).
• Utah Division of Real Estate and local landlord-tenant resources.

> ⚠️ Template example, not professional (legal/financial/medical) advice. Verify current requirements with Utah statutes and consult legal counsel. Application fees must be disclosed as non-refundable. Use objective criteria consistently. [[Merge Fields]] for user inputs. Obtain legal advice for specific use.

End of Utah Residential Rental Application