Rhode Island Residential Rental Application and Screening Packet

Rhode Island Residential Rental Application and Screening Packet

Use one packet per adult applicant. Rhode Island prohibits rental application fees.

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.

Rhode Island Screening-Cost Module

• Rental application fee charged: ☐ No
• Applicant provided an official state criminal background check issued within 90 days: ☐ Yes ☐ No
• Applicant provided a credit report issued within 90 days: ☐ Yes ☐ No
• If no qualifying report was provided, actual cost charged: $[________]
• Copy of landlord-obtained report delivered on: [__/__/____]

Do not charge a rental application fee. If the applicant supplies a required official state criminal background check or credit report issued within 90 days, charge no fee for that report. Otherwise, a landlord may charge no more than the actual cost of obtaining the required report and must provide a copy. A landlord may obtain an independent report at the landlord's own expense. R.I. Gen. Laws § 34-18-59.

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 Rhode Island 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 Rhode Island fee 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 ☐ Official state criminal check ☐ Other: [________]
• Authorization expires: [__/__/____]

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

6. Cost Receipt and Decision Record

• Amount/character: $[________] ☐ No charge ☐ Actual-cost report charge
• Vendor invoice attached: ☐ Yes ☐ Not applicable
• Report copy provided: ☐ Yes ☐ Applicant supplied report ☐ 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)
• R.I. Gen. Laws § 34-18-59 — https://webserver.rilegislature.gov/Statutes/TITLE34/34-18/34-18-59.htm