Mississippi Rental Application Form

What the Mississippi rental application is

This two-page fillable PDF, titled "Mississippi Rental Application," is a standard screening form for apartments and rental houses. It asks for your personal details, other occupants, three residences, three jobs, bank and credit accounts, vehicles, references, and answers to general screening questions, and it closes with an Agreement & Authorization you sign. It is a general template, not a form issued by the State of Mississippi or any state agency. Mississippi does not publish an official rental application.

Who uses it

Mississippi landlords, property managers, and owners renting a single home use it to collect the same information from every applicant. Renters use it when a landlord asks for a completed application before a showing or before signing a lease.

What to have ready

• Addresses, rent amounts, and landlord contact numbers for your current home and two earlier homes
• Employer details, supervisor names, and monthly gross pay for your current and two earlier jobs
• Bank names and balances for savings and checking, plus credit card and auto loan balances
• Vehicle make, model, color, year, and plate for everyone who will park at the property
• Names, birth dates, and relationships of other occupants

How to fill it out online

Click "Fill Template Now," type into each field on the PDF, sign in the Applicant Signature box, and download the finished file. Here is what each section of this form asks for.

Page 1

• Applicant: First Name, Middle, Last, Birth Date, Social Security #, Driver's License #, Any Other Names You've Used In The Past, Home Phone, and Cell Phone.
• All Other Proposed Occupants: rows for each additional person's name, Birth Date, and Relationship To Applicant.
• Rental/Residence History: three columns for your Current, Previous, and Prior Residence. Each asks for Street Address, City, State & Zip, Last Rent Amount Paid, Owner/Manager and Phone Number, Reason for leaving, and three yes or no questions: "Is/Was rent paid in full?", "Did you give notice?", and "Were you asked to move?" Below the columns you list the Name(s) in which your utilities are now billed and the From/To dates of residency.
• Employment History: Current, Previous, and Prior Employment, each with Employed By, Address, Employer's Phone, Occupation, Name of Supervisor, Monthly Gross Pay, and From/To dates.
• Credit History: the Bank/Institution Name and the Balance On Deposit or Balance Owed for a savings account, checking account, credit card, and auto loan.
• Vehicles: two rows for Make, Model, Color, Year, and License Plate. The form asks you to include vehicles that belong to other proposed occupants.

Page 2

• References & Emergency Contacts: name, street address, city, state and zip, and phone number for a Doctor, a Lawyer, and your Nearest Relative Living Elsewhere. The printed text says that by signing you allow the landlord to contact these people if you cannot be located, and to let the listed relative remove your belongings if the apartment is abandoned. Read that sentence before you fill in the names.
• General Information: short answers about late rent notices, smoking, expected length of stay, bankruptcy, move-in date, felony convictions, eviction notices, pets (type, breed, approximate weight and age), problems with your current landlord, why you are moving, optional verifiable income sources, someone who could lend you rent money, past lawsuits, anything negative a credit or criminal check may show, how you heard about the apartment, your email address, and referrals.
• Agreement & Authorization: the Applicant Signature and Date fields.

Signing and submitting

The Agreement & Authorization paragraph says your statements are true, authorizes a credit and/or criminal check and contact with everyone listed, and states that the application is not a lease and that the processing fee is non-refundable even if you do not get the apartment. Sign in the signature field (see how to sign a PDF online), add the date, download the PDF, and send it to the landlord or property manager the way they ask, usually by email or a printed copy. Keep a copy for your records.

Mississippi rules that affect rental applications

General information as of October 2026, not legal advice. Mississippi's Residential Landlord and Tenant Act is found at Miss. Code Ann. sections 89-8-1 through 89-8-29.

• Application fees: we did not find a Mississippi statute that limits rental application or screening fees. This form says the processing fee is non-refundable, so ask for the amount up front.
• Deposit amount: section 89-8-21, the Act's security deposit section, does not set a maximum deposit amount.
• Deposit return: under section 89-8-21, any remaining deposit must be returned within 45 days after the tenancy ends, the tenant gives up possession, and the tenant asks for the deposit back. Deductions for unpaid rent, cleaning, or damage beyond normal wear and tear must be listed in a written, itemized notice. The Mississippi State Department of Health's guide for tenants and landlords summarizes this rule and notes that the tenant must request the deposit when moving out.
• Screening: this form asks about felony convictions, evictions, and bankruptcy and authorizes credit and criminal checks. Federal fair housing law still applies to how landlords use that information.

Comparing forms from neighboring states? See the Alabama rental application or browse all real estate forms.

Common mistakes

• Listing only your current home. Landlords use the Previous and Prior Residence columns to check rental history.
• Using take-home pay in Monthly Gross Pay. Enter pay before taxes.
• Leaving out occupants' vehicles, which the Vehicles section specifically asks for.
• Answering the bankruptcy and eviction questions with "yes" but no date, when the questions ask "If so, when?"
• Forgetting to date the signature or keep a copy of the signed PDF.