Nebraska Rental Application Form

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The Nebraska Rental Application Form grants property owners and managers the ability to screen applicants competing for the same rental property. The main concern of every Property Owner seeking to lease out a residential property is to find a Tenant who will reliably pay his/her rent on time. Also, since most properties will have a reasonable turn-over of Tenants as time goes on, Property Owners wish to find one that will not damage the property or the surrounding area in general. These are just two of the qualities that Landlords, Property Owners, and Property Managers need a candidate to demonstrate he or she possesses. This application form will provide the guidance for a candidate to do so as well as a level of organization which will aid the application review process.

In addition to the information a prospective candidate will provide, this application will also contain a Residency Verification Form, and a signature line which allows the applicant to attest to the accuracy of the information has filled in. Note: There will be some areas the office or landlord who requires this application for review must fill out as well and others that are labeled for Office Use Only. This application should not be considered valid unless all the information that must be provided by the Tenant and Property Manager are filled out completely.

How to Write

For Office

Step 1 – In the box, located in the top left corner of the first page, enter the Application Fee that must be submitted with this application on the first blank space. Then enter the fee if an Additional Adult will be applying with the Applicant in the second blank space.

Step 2 – In the box, located in the top right corner of the first page, the first blank space is reserved for the office personnel who has received the completed application. The next two blank spaces must have the Date and Time the application was received by the office. Finally mark the last two blank spaces if the Application Fee and Deposit was submitted with the application.

For Tenant

Step 1 – On the first line, enter the Address of the property, you are applying for.

Step 2 – On the line labeled “Legal Name,” enter your First Name, Middle Name, and Last Name in the appropriate areas.

Step 3 – On the next line enter your Social Security Number, Date of Birth, Driver’s Likens Number, and State. If you have a spouse applying for this unit with you he/she must provide the same information as in Steps 1 and 2 next to the word “Spouse.”

Step 4 – The second section will have two columns. The column on the left will require you to enter your Current Street Address on the first blank space. Below this enter the city, State, and Zip Code of your residence. On the next line, report how long you have lived there in the first space and your Current Rent in the second space. The next line requires the Current Landlord’s full name while the last line shall require that Landlord’s phone number.

Step 5 – In the second column of the second section, enter your phone number on the first line. Below this enter your Email Address. The next line requires you indicate if you have given proper notice, place a check mark next to “Yes” if so. If not, place a check mark next to the word “No.” Below this, enter your current Landlord’s Address. Finally, on the last line in this column, state the reason you are moving.

Step 6 – In section 3, “Previous Address,” enter the Address and Zip Code of the last place you lived. Then on the rest of the line, enter the Date range you lived there (i.e. 1/1/15-1/1/16), the name of your previous Landlord, the Phone Number of your previous Landlord, and the Address of your previous Landlord’s Address.

Step 7 – The fourth and fifth sections will be reserved for income information from your spouse and yourself. Both will require the same information, if you are unmarried skip the section labeled spouse. On the first line, in the fourth section, enter the name of your Current Employer then your Employer’s Address and Zip Code. The second line will require the Employer’s Phone Number, your Job Title, and the Dates you’ve been employed there for. Finally, on the third line, enter the Name of your Supervisor, your Gross Income per year, and your Gross Income per month. The will be a line below the section for your spouse for either of you to report Other Income. Here, enter the Source of your other income then the amount earned per month.

Step 8 – In section six, enter the full name, relationship, and age of each individual who will be living in the premises with you. On the line below this (bolded) describe how you heard about the property rental.

Step 9 – In the section labeled “Personal History,” there will be several yes/no questions which must be addressed. If you answer “Yes” to having a felony, you must indicate which year. Also, if you answer “Yes” to having a pet, you must describe the kind of pet you have, its weight, and, if a dog, its breed in the spaces provided. Finally, if you answer “Yes” to ever being asked to move out or evicted, you must provide the year in the space provided. The bottom of this section will provide several blank lines. If you have answered “Yes” to any of the questions, you must give a detailed explanation in these blank lines.

Step 10 – In the eight section, give the details to your emergency contact. On the first line, enter the Full Name, Address, City, State and Zip Code of your emergency contact. Then on the second line, enter the Home Phone Number, Work Phone Number, Cell Number, and Relationship for this individual.

Step 11 – In the section labeled “Vehicles,” there will be enough room to report specifics on two vehicles (if you own more however, you must list the same information for them). For each vehicle, enter its Make/Model, Year, Color, and License Plate Number.

Step 12 – You must sign and date the bottom of this document on the left. Then enter the desired possession date, rent amount, deposit amount, application fee, and lease term (how long it is). Sign the bottom right of this page as well and check off which utilities you will be responsible to pay for.

Step 13 – Attached to this application will be a “Residency Verification Form,” here your spouse and yourself must sign your name and date the signature. This will give permission for a reference using the questions below to be gained. Do not fill out any of these questions


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