Illinois Residential Rental Application and Screening Packet

Illinois Residential Rental Application and Screening Packet

Use one packet per adult applicant. Give the criteria and reusable-report notice before collecting a screening fee.

Privacy rule: Do not place sensitive identifiers or financial-account numbers in this packet. Collect identity credentials only through a separately approved secure channel with access controls and a retention schedule.

Illinois Reusable Tenant-Screening Report Module

• ☐ Applicant will provide no reusable report.
• ☐ Applicant provided a reusable report prepared within the previous 30 days at the applicant's request and expense.
• Report provider/direct-access method: [________________________________]
• Report is available to the landlord at no access or use cost: ☐ Yes
• Report contains every criterion consistently used for screening: ☐ Yes
• Applicant states no material change has occurred: ☐ Yes

If the report satisfies 765 ILCS 705/25, do not charge a fee to access it or an application-screening fee. The landlord may process a separate application but may not charge an additional screening fee. A local rule providing greater applicant protection controls.

Future-law watch: The General Assembly's P.A. 104-0479 page lists an effective date of January 1, 2027. For covered leases after that date, the new 765 ILCS 705/35 generally caps rental-application/background-check fees at $50, subject to its actual-cost third-party exception and other limits. Update this module before that date.

1. Property and Housing Provider

• Property address/unit: [________________________________]
• Monthly rent/proposed move-in/term: [________________________________]
• Housing provider/agent and notice address: [________________________________]
• Completed application received: [__/__/____] at [____] ☐ a.m. ☐ p.m.

2. Written Screening Criteria

Apply criteria consistently. Do not discriminate because of race, color, religion, sex, disability, familial status, or national origin. 42 U.S.C. § 3604. Check additional Illinois and local protected classes.

3. Applicant Information

• Full legal name/name used for references: [________________________________]
• Email/telephone: [________________________________]
• Current address and time there: [________________________________]
• Requested move-in date: [__/__/____]
• Other proposed occupants/relationship: [________________________________]
• Animals: [________________________________]
• Confidential assistance-animal process requested: ☐ Yes ☐ No

4. Residence and Income History

5. Applicant Statements and Consumer-Report Authorization

• ☐ Information is complete and accurate to the best of the applicant's knowledge.
• ☐ Applicant received criteria and reusable-report notice before payment.
• ☐ Applicant received the privacy/retention notice.
• ☐ Applicant understands this is not a lease or promise of approval.

I give written instructions authorizing [HOUSING PROVIDER/AGENT] and [CONSUMER REPORTING AGENCY] to obtain and use the checked reports solely for this rental application and lawful account review. 15 U.S.C. § 1681b(a)(2).

• Agency/address/telephone: [________________________________]
• Reports: ☐ Credit ☐ Rental history ☐ Eviction records ☐ Criminal records ☐ Other: [________]
• Authorization expires: [__/__/____]

Applicant signature: [________________________________] Date: [__/__/____]

6. Fee Receipt and Decision Record

• Amount/character: $[________] ☐ No fee ☐ Screening fee ☐ Refundable deposit
• Reusable report barred a fee: ☐ Yes ☐ No
• Payment reference, no full account number: [________________________________]
• Criteria applied exactly as disclosed: ☐ Yes
• Decision: ☐ Approved ☐ Conditional approval ☐ Denied ☐ Withdrawn
• Criterion and verified fact: [________________________________]
• Consumer report affected decision: ☐ Yes ☐ No
• Decision maker/date: [________________________________]

7. Adverse-Action Notice

Applicant/property/date: [________________________________]

Action and specific reason: [________________________________]

Consumer report used for this decision: We based this decision in whole or in part on information in a consumer report furnished by [AGENCY NAME], [AGENCY ADDRESS], [AGENCY PHONE AND NATIONAL TOLL-FREE NUMBER IF APPLICABLE]. The agency did not make this decision and cannot give you its specific reasons. You have a right to a free copy of your report from the agency if you request it within 60 days after receiving this notice and to dispute the accuracy or completeness of information in it with the agency. 15 U.S.C. § 1681m(a).

Numerical credit score used for this decision: Score [____]; possible range [____]; key factors adversely affecting the score [____]; date created [__/__/____]; person or entity that provided the score or underlying credit file [____]. 15 U.S.C. §§ 1681m(a)(2), 1681g(f)(1)(B)-(E).

Housing provider/agent signature: [________________________________]

Sources and References

• 15 U.S.C. § 1681b — https://uscode.house.gov/view.xhtml?req=(title:15%20section:1681b%20edition:prelim)
• 15 U.S.C. § 1681m — https://uscode.house.gov/view.xhtml?req=(title:15%20section:1681m%20edition:prelim)
• 42 U.S.C. § 3604 — https://uscode.house.gov/view.xhtml?req=(title:42%20section:3604%20edition:prelim)
• 765 ILCS 705/25 — https://www.ilga.gov/Legislation/publicacts/view/103-0840
• P.A. 104-0479 — https://www.ilga.gov/Legislation/PublicActs/View/104-0479