Attorney-Approved Rental Application Template for Mississippi

Mississippi Rental Application Template

This rental application is designed to comply with the relevant provisions and protections under the Mississippi Landlord and Tenant Act. It serves as a tool to assist landlords in gathering necessary information from potential tenants to make an informed decision about a lease agreement. All applicants are encouraged to read the application thoroughly and provide accurate information to the best of their knowledge.

Applicant Information:

• Full Name: ____________________________
• Date of Birth: ________________________
• Social Security Number: ________________
• Phone Number: _________________________
• Email Address: ________________________
• Current Address: ______________________
• City: ____________ State: _____________ Zip: ________

Rental History:

1. Current/Most Recent Landlord: ___________________________________
2. Landlord Phone Number: _________________________
3. Monthly Rent Amount: $____________
4. Dates of Tenancy: From ___________ To ___________
5. Reason for Leaving: _________________________

Employment Information:

• Current Employer: ___________________________
• Position: _________________________________
• Employer Phone Number: _____________________
• Monthly Income: $__________________________
• Other Sources of Income: ___________________
• Income Amount: $___________________________

By signing below, the applicant authorizes the landlord or property manager to conduct a full background and credit check. The applicant affirms that all the information provided on this application is true and complete. Any false or misleading information may be grounds for rejection of this application, termination of the lease agreement, or further legal action.

Signature: _____________________________ Date: ____________

Landlords in Mississippi should note that rejection of an application based on discriminatory factors that violate the Fair Housing Act is illegal. These factors include race, color, national origin, religion, sex, familial status, and disability. Landlords are encouraged to base their tenant selection process on criteria that reflect the applicant's ability to comply with the terms of the lease and responsibly maintain the property.