Applicant Name: ______________ Date Contacted: ______
Room Available Date: ______ Desired Move-In Date: _______
Room Shown? [ ] Yes [ ] No Application Received? [ ] Yes [ ] No
1. First Contact Screening
Use this section when the applicant first calls, texts, emails, or responds to the ad.
Basic Questions
What date are you hoping to move in? _____________
How long do you expect to rent? __________________
Are you applying for yourself only? [ ] Yes [ ] No
Will anyone else stay with you regularly? [ ] Yes [ ] No
Explanation: ________________________________________________________________________________________
Do you understand this is a room in a shared home, not a private apartment? [ ] Yes [ ] No
Are you comfortable with written House Etiquette Guidelines? [ ] Yes [ ] No
Are you comfortable with quiet time, visitor limits, no unauthorized overnight guests, shared kitchen rules, and shared bathroom expectations? [ ] Yes [ ] No
First Contact Impression
[ ] Communicated clearly
[ ] Answered questions directly
[ ] Seemed respectful
[ ] Seemed rushed or desperate
[ ] Avoided basic questions
[ ] Asked reasonable questions
[ ] Asked about pets
[ ] Asked about couples / another occupant
[ ] Asked about smoking / vaping
[ ] Asked about overnight guests
Notes:
2. Move-In Timing
[ ] Applicant can move in within a reasonable time after room becomes available.
[ ] Applicant wants to delay move-in more than two weeks.
[ ] Delay may be acceptable because applicant appears to be a high-quality long-term prospect.
Reason for timing:
Decision:
[ ] Continue screening
[ ] Hold for later
[ ] Decline / not a good fit
3. Employment and Income Review
Current Employer: _________________________________
Position: ________________________________________
Start Date: ______________________________________
Gross Monthly Income: $___________________________
[ ] Applicant provided proof of income.
Type of proof: ______________________________________
[ ] Income appears sufficient for rent.
[ ] Income is questionable.
[ ] Income cannot be verified.
If current employment is less than 6 months, recently relocated, or recently changed jobs:
Previous Employer: _______________________________
Dates Employed: From ___________ To ___________
Reason for Leaving: ______________________________
[ ] Previous employment history appears stable.
[ ] Job change was due to relocation.
[ ] Job change appears reasonable.
[ ] Employment history raises concern.
Relocation Question
[ ] Applicant is relocating for employment.
Employer / job location: ______________________________
Expected start date: _________________________________
Income / Employment Notes:
4. Transportation Review
[ ] Applicant has reliable transportation.
[ ] Applicant has valid driver’s license.
[ ] Applicant owns or has regular access to vehicle.
[ ] Applicant does not have reliable transportation.
Vehicle:
Year / Make / Model: _________________________________
Plate #: _________ State: ___
If no vehicle or no driver’s license, explain transportation plan:
Transportation Concern?
[ ] No concern
[ ] Minor concern
[ ] Major concern
5. Housing History Review
Current Housing
Current Address: ___________________________________________
Dates Lived There: From ____________ To ____________
Current Landlord / Manager: _______________________
Rent Current? [ ] Yes [ ] No
Reason for Leaving: _____________________________
[ ] Current landlord contacted.
[ ] Rent payment history confirmed.
[ ] No problems reported.
[ ] Concerns reported.
Previous Housing
Previous Address: _______________________________
Dates Lived There: From ____________ To _____________
Previous Landlord / Manager: ________________________
Rent Current When Left? [ ] Yes [ ] No
Reason for Leaving: ______________________________
[ ] Previous landlord contacted.
[ ] Rent payment history confirmed.
[ ] No problems reported.
[ ] Concerns reported.
Housing Stability Review
[ ] Stable housing history
[ ] Frequent moves
[ ] Gaps in housing history
[ ] Prior eviction
[ ] Moved owing rent or damages
[ ] Explanation appears reasonable
[ ] Explanation raises concern
Notes:
6. In-Person Meeting / Showing
Appointment Date: _________
Showed Up On Time? [ ] Yes [ ] No
Rescheduled? [ ] Yes [ ] No
No-show? [ ] Yes [ ] No
During the showing, applicant:
[ ] Was respectful of the home
[ ] Asked reasonable questions
[ ] Appeared comfortable with shared living
[ ] Reacted positively to House Etiquette Guidelines
[ ] Reacted negatively to rules
[ ] Seemed financially prepared
[ ] Seemed unstable or uncertain
[ ] Seemed overly rushed
[ ] Seemed like a good fit with current housemates
Car / Vehicle Observation
[ ] Vehicle interior appeared reasonably clean
[ ] Vehicle interior was extremely messy
[ ] Vehicle condition raised concern
[ ] Not applicable
Showing Notes:
7. House Etiquette Review
[ ] Applicant received House Etiquette Guidelines.
[ ] Applicant read the guidelines.
[ ] Applicant asked reasonable clarification questions.
[ ] Applicant agreed to follow the guidelines.
[ ] Applicant objected to one or more rules.
Rules that caused concern:
[ ] Quiet time
[ ] Visitors
[ ] Overnight guests
[ ] Smoking / vaping
[ ] Pets
[ ] Kitchen cleanup
[ ] Bathroom cleanliness
[ ] Food sharing
[ ] Parking
[ ] Bedroom cleanliness
[ ] Other: _________________________________________
Decision after House Etiquette review:
[ ] Continue screening
[ ] Need more discussion
[ ] Decline / not a good fit
8. Application Review
[ ] Application completed fully.
[ ] Application was readable.
[ ] Legal name matches government-issued ID.
[ ] Driver’s license / state ID reviewed.
[ ] Copy of ID obtained if appropriate.
[ ] Social Security number provided if required for screening.
[ ] Contact information complete.
[ ] Employment information complete.
[ ] Housing history complete.
[ ] References complete.
[ ] Applicant signed authorization.
Missing Information:
9. Credit / Financial Review
Credit report reviewed:
Current late bills? [ ] Yes [ ] No
Collections? [ ] Yes [ ] No
Eviction record? [ ] Yes [ ] No
Bankruptcy? [ ] Yes [ ] No
If yes, year filed: _________________________________
Financial concerns:
[ ] Current rent not paid
[ ] Current late bills
[ ] Utility collections
[ ] Auto loan repossession / serious auto debt
[ ] Recent bankruptcy
[ ] Frequent address changes
[ ] Debt issue appears old or explainable
[ ] Medical bills / divorce / job loss explanation appears reasonable
Financial Review Notes:
10. Background Check Process
Before running background check:
[ ] Government-issued ID reviewed.
[ ] Legal name verified exactly as shown on ID.
[ ] Date of birth verified.
[ ] Current address verified.
[ ] Application name matches ID.
[ ] Nickname or alternate name noted.
Background check completed:
[ ] Criminal background reviewed.
[ ] Sex offender search reviewed.
[ ] Eviction history reviewed.
[ ] Court records reviewed, if applicable.
[ ] Results match applicant’s disclosures.
[ ] Applicant explanation requested, if needed.
Automatic or Serious Concern Areas
[ ] Violence
[ ] Theft
[ ] Sexual misconduct
[ ] Drug trafficking
[ ] Property damage
[ ] False information on application
[ ] Undisclosed felony
[ ] Other serious concern: ____________________________
Background Check Notes:
11. References
Emergency Contact
[ ] Contact information provided.
[ ] Appears valid.
Personal Reference
Name: ____________________ Relationship: ________
Contacted? [ ] Yes [ ] No
Comments:
Additional Reference
Name: ____________________ Relationship: _________
Contacted? [ ] Yes [ ] No
Comments:
12. Red Flags
Check any that apply:
[ ] Wants to move in immediately without screening
[ ] Cannot verify income
[ ] Cannot afford move-in amount
[ ] Gives vague answers
[ ] Has unreliable transportation
[ ] Has frequent recent moves
[ ] Is currently late on major bills
[ ] Has recent eviction
[ ] Objects to House Etiquette Guidelines
[ ] Wants unauthorized occupant
[ ] Wants pets when pets are not allowed
[ ] Wants regular overnight guests
[ ] Smokes or vapes indoors
[ ] Application information does not match ID
[ ] Refuses background check
[ ] Provides incomplete application
[ ] No-shows or repeatedly reschedules
[ ] Vehicle or personal habits raise cleanliness concerns
[ ] Your intuition says this is not a good fit
13. Positive Signs
Check any that apply:
[ ] Stable employment
[ ] Verifiable income
[ ] Good communication
[ ] Respectful during showing
[ ] Comfortable with shared living
[ ] Accepts House Etiquette Guidelines
[ ] Has reliable transportation
[ ] Housing history makes sense
[ ] Moving for reasonable purpose
[ ] Relocating for employment
[ ] References are positive
[ ] Credit issues are old or explainable
[ ] Seems like a good fit for the household
14. Final Decision
[ ] Approved
[ ] Declined
[ ] Hold / Need more information
Reason for decision:
Conditions before move-in:
[ ] First month’s rent collected
[ ] Security deposit collected
[ ] Rental Agreement signed
[ ] House Etiquette Guidelines signed
[ ] Move-In Checklist completed
[ ] Key issued
[ ] Door code issued
[ ] Room condition documented
The Live-In Landlord Starter Kit
Everything You Need to Turn an Empty Bedroom into Reliable Monthly Income