Residential Tenant Intake — Pannasch Realtor

Full Legal Name *

Date of Birth

Email Address *

Phone Number *

Preferred Contact Method

Call Text Email

Current Address

How long at your current address?

Reason for Leaving Current Residence

Current Landlord Name

Current Landlord Phone / Email

List every person who will live in the property. Landlords screen all adults. All occupants over 18 will be required to apply and sign the lease.

Total Number of Occupants (all ages, including you) *

Number of Occupants Over Age 18 *

Adult Occupant #2 (if applicable)

Full Name

Relationship to You

Age

Adult Occupant #3 (if applicable)

Full Name

Relationship to You

Age

Adult Occupant #4+ (if applicable — list all additional)

Names, relationships, and ages

Number of Minor Children (under 18) who will reside in the property

Do you have any pets? *

No pets Yes — I have pet(s)

Landlords typically require monthly income of 2.5–3× the monthly rent. This section is used to confirm general qualification prior to showing.

Employment Status *

Employed full-time Employed part-time Self-employed Retired Student Unemployed / Between jobs

Employer / Business Name

Length of Employment / Self-Employment

Monthly Gross Income Range — Primary Applicant *

Combined Household Monthly Income (all adult occupants)

Income Source(s) (check all that apply)

W2 wages Self-employment / 1099 Social Security / disability Pension / retirement Rental income Investment income Section 8 / housing voucher

Your estimated FICO / credit score range *

Excellent — 750+ Good — 700–749 Fair — 650–699 Below average — 600–649 Poor — below 600 Not sure

Are there any open collections, judgments, or liens on your credit report?

No Yes Not sure

These are standard pre-screening questions asked by landlords in New Jersey. Answering honestly upfront saves everyone time. Providing false information will disqualify an application.

⚠ Eviction History

Have any of the prospective occupants (including yourself) ever been evicted, or had an eviction filing, eviction proceeding, or unlawful detainer action brought against them — regardless of outcome?

No — never Yes

⚠ Bankruptcy

Have any of the prospective occupants filed for bankruptcy within the last 7 years?

No Yes

⚠ Criminal History

Have any of the prospective occupants been convicted of a felony? (Note: NJ law limits how landlords may use this information. Disclosure here is for pre-screening only and does not automatically disqualify you.)

No Yes Prefer not to answer at this time

Minimum Bedrooms *

Minimum Bathrooms

Preferred Towns / Areas *

Maximum Monthly Rent Budget *

Can you pay first month + last month + security deposit upfront?

Yes — can pay all upfront First + security only Need to discuss

Target Move-In Date *

ASAP — within 30 days 1–2 months 2–3 months 3–6 months

Preferred Lease Term

Month-to-month 1 year 2 years Open to landlord preference

How many vehicles will be kept at the property?

Any commercial, oversized, or specialty vehicles?

No Yes

Do any occupants smoke? (cigarettes, cigars, vaping, etc.)

No — nobody smokes Yes — indoors Yes — outdoors only

Personal Reference — Name

Personal Reference — Phone / Email

Any additional details or context you'd like to share

How did you hear about us?

✓ Form Submitted Successfully

Thank you! I'll review your information and be in touch within one business day to discuss available properties.
— Clayton Pannasch, Pannasch Realtor with Fairclough Realtors

This is a pre-screening intake only. A formal application with full credit check will follow for qualified applicants.