Rental Application

Each application has a $40.00 fee of which $11.50 can be made payable to Aterra Real Estate and submitted using the online payment portal or via check to 1001 Grand Ave. The remaining $28.50 will be paid to 3rd party background check after we receive completed application. Aterra Real Estate may request additional documentation including but not limited to: Photo ID, pay stubs, signatures or other affirmations.

Name*
First Last
Phone*
Email
Address*
Street Address City Desired Move-In Date
DOB*
Date Format: MM slash DD slash YYYY
Driver's License #
SSN*
xxx-xx-xxxx
Current Housing Information*
Address Move In Date Rent/Mortgage ($) Landlord/Mortgage Company Landlord/Mortgage - Contact Reason for Leaving
Prior Housing Information
Address Move In Date Move Out Date Rent or Own? Landlord/Mortgage Company Landlord/Mortgage - Contact Reason for Leaving
Employment/Income*
Employer/Source of Income Phone Number Business Address Position Start Date Supervisor Monthly Income
Credit References*
Creditor Account # Balance Monthly Payments
Personal References*
Name Phone Number Address Relation

(Related to applicant)
Emergency Contact*
Name Phone Number Address Relation

Note: In the event rent is ever more than six (6) days past due and manager has been unable to reach any lessee by phone, email, or regular mail, your submission of this form indicates approval that Property Manager may contact the above listed "Emergency Contact" as this may be an indication of an emergency.
Pet Information
Breed Age Pet Name Veterinary Clinic Spayed/Neutered Declawed

Pets may have additional requirements for tenancy at certain locations.
Vehicle Information*
Year Make Model License # State
Questionnaire*
- I have never been evicted
- I have never moved without proper notice to landlord
- I have never willfully or intentionally refused to pay rent
- I have never filed bankrupcty
- I have never been convicted of a felony or misdemeanor
- I am obligated to pay child support or alimony
- I plan to conduct commercial business from the residence
Please select all that apply.
Untitled*
- Applicant hereby acknowledges and grants approval for the owner/property manager to perform a background check in confidence for past evictions, criminal offenses, verification of current and past employment, previous landlords, identity and to obtain a credit report. These will be used as we consider the applicant for approval for residency in a rental property. If approved, this application will become a part of our agreement.
- Applicant acknowledges that once the background checks are complete the application fee is non-refundable.
- Applicant acknowledges once a deposit is places by applicant to hold the unit for which applicant has been approved for residency, such deposit will not be refunded, to the extend that costs are incurred by owner (e.g. lost rent from reserving the unit for applicant and additional advertising, and/or other direct costs.).
- False information listed on the application may be grounds for denial of occupancy and/or ground for eviction, per Iowa Code 714.8(10).
Thoroughly read each section & check each box to acknowledge that you understand & agree to the terms.

Employer/Source of Income	Phone Number	Business Address	Position	Start Date	Supervisor	Monthly Income

Creditor	Account #	Balance	Monthly Payments

Breed	Age	Pet Name	Veterinary Clinic	Spayed/Neutered	Declawed

Year	Make	Model	License #	State