Maryland Residential Rental Application and Screening Packet

Maryland Residential Rental Application and Screening Packet

Use one packet per adult applicant. Complete the statutory fee statement before the applicant signs.

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.

Maryland Application-Fee Statement

By signing this application, the applicant incurs only these stated liabilities: [________________________________]. If fees other than a security deposit exceed $25, the housing provider may retain only amounts actually spent for a credit check or other application expense and must return the unspent balance within 15 days after occupancy or written notice by either party that no tenancy will occur. Md. Code Ann., Real Prop. § 8-213(a)-(b).

• Total non-security-deposit fees: $[________]
• Actual credit-check/vendor expense: $[________]
• Other actual application expense: $[________]
• Refund due: $[________] by [__/__/____]
• Exemption claimed: ☐ None ☐ Four or fewer units at one parcel/location ☐ Seasonal rental ☐ Condominium rental

The statutory refund rule does not apply to the exempt rentals listed in § 8-213(c); separate contract and consumer-law duties may still apply.

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 Maryland 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 the criteria and § 8-213 statement before signing.
• ☐ 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 ☐ Application fee ☐ Refundable deposit
• Payment reference, no full account number: [________________________________]
• Actual expenditure documentation attached: ☐ Yes ☐ Not applicable
• 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: [________________________________]

If a consumer report affected the action, identify the agency, address, telephone, score and required score factors if used. The agency did not make the decision. The applicant may request a free report within 60 days and dispute inaccurate or incomplete information. 15 U.S.C. § 1681m(a).

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)
• Md. Code Ann., Real Prop. § 8-213 — https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=grp&section=8-213