Nebraska landlord · tenant screening

Nebraska Residential Rental Application

Download the Nebraska residential rental application — screens prospective tenants with application-money elections, a standalone screening-report authorization, and the disclosures federal and Nebraska law require — in fillable Word and fillable PDF, with the Nebraska Completion & Compliance Guide.

Fillable Word + fillable PDF
Nebraska Completion & Compliance Guide included
Completed sample available
Instant secure download

Renting out property in more than one state? This page is the Nebraska application — each state's edition is built to its own screening and application-money law.

All states — Rental Applications Leases & real estate forms hub

What's in your Nebraska download

Every file below is included: the fillable Word application, a fillable PDF, the Nebraska Completion and Use Guide, the PL-NE-RA02 Lincoln Source-of-Income Rider, and the federal FCRA Summary of Your Rights.

Included files

Nebraska Residential Rental Application Core application — completes on screen in the fillable PDF or in Word, then print and sign Word PDF
Nebraska Completion & Compliance Guide Money elections, criteria timing, deadlines, refunds, adverse action, and recordkeeping — editable Word; print-ready PDF Word PDF
lincoln-rider-rentlapp-NE.pdf Included file PDF
FCRA Summary of Your Rights (CFPB) The federal consumer-rights summary that ships with every screening package — print-ready PDF PDF

Preview the actual form

The real document — not a mockup. Page 1 of the form included in your download.

Get This Form — $9.99

Page 1 of the Nebraska Residential Rental Application form — Form PL-NE-RA01 · Page 1 of the actual Nebraska document included in your download.

Inside the Nebraska application

Every part of the form, in order — the application summary, 17 sections, and the office-use panel.

Application summary The reasonable-accommodation contact line, property applied for, requested move-in date, offered rent, and stated security deposit.
1. Application Money Disclosure
2. About You Identity, contact channels, an electronic-notice election with a paper-mail alternative, and identity-document choices (SSN, ITIN, government-issued ID, or a lawful alternative) — no date-of-birth field anywhere on the form.
3. Other Proposed Occupants Household composition with a separate-signed-application election for each person — ages, birth dates, and adult/minor classifications are never collected; every other adult completes and signs a separate application.
4. Pets and Assistance Animals Household pets only; service and assistance animals are handled as fair-housing accommodations, never as pets.
5. Residential History Current and prior addresses, housing payments, owner/manager contacts, and an optional neutral move reason.
6. Employment & Income Employment plus any lawful source of income, with the Nebraska source-of-income note.
7. Banking or Asset Verification An optional verification election; the form never collects account numbers.
8. References and Emergency Contact An optional personal reference and an emergency contact that is not used for screening.
9. Vehicle Information Vehicle details where parking is requested.
10. Additional Information An open area for lawful qualification information.
11. Screening Criteria Election
12. Reusable or Portable Tenant-Screening Reports
13. Screening Information and Legal Limits
14. Consumer Report Disclosure How consumer reports are obtained and the adverse-action notice commitment.
15. Privacy, Retention, and Disposal Data-minimization commitments under the FCRA and its Disposal Rule.
16. Applicant Declaration The signed certification of accuracy with a verification-contact authorization; electronic and copied signatures honored.
17. Screening Report Disclosure and Authorization The standalone signed authorization, investigative-report notice, agency identification, free-report-copy election, and the federal Summary-of-Your-Rights package insert.
For Office Use Only

About this form

A residential rental application is the landlord's first line of protection: it collects the applicant's identity, household composition, rental history, employment and income, and references, and it carries the disclosures and signed authorizations that make lawful tenant screening possible before a lease is signed.

Nebraska has no statewide rental-application-fee statute. This edition therefore uses a clear advance fee disclosure and uniform-treatment workflow without suggesting a statutory cap.

Neb. Rev. Stat. § 20-318 adds military or veteran status and categorically prohibits inquiries or records concerning protected characteristics. The included PL-NE-RA02 rider covers Lincoln’s source-of-income protections and requires source-identifying questions to be removed.

100% satisfaction guarantee

ILRG provides self-help legal forms and download support. PublicLegal landlord forms are provided for you to complete with your own property and screening information. Screening rules vary by state and change frequently — the Completion & Compliance Guide explains the rules in your state and the steps that keep this application within them. If you are not 100 percent satisfied after purchasing from us, contact us for a refund.

Frequently Asked Questions About Nebraska Rental Applications

Does Nebraska cap rental application fees?

No statewide Nebraska statute sets an application-fee cap. Disclose any fee before collection, explain what it covers and whether it is refundable, provide a receipt, and apply the policy uniformly.

May the application collect protected-class information?

No. Neb. Rev. Stat. § 20-318(5) categorically prohibits written or oral inquiries or records concerning the protected characteristics listed in that section.

Which additional statewide fair-housing class applies?

Neb. Rev. Stat. § 20-318 includes military or veteran status. It is an equal-housing notice class, not an application data field.

What changes for a Lincoln property?

Use Form PL-NE-RA02 and remove every question identifying a lawful income source. Lincoln permits verification of amount and ability to pay but prohibits source-of-income inquiries and records.

What is included?

The six-page Nebraska application in fillable Word and PDF, a Completion & Use Guide, the Lincoln Source-of-Income Rider, and the federal FCRA Summary of Rights. A completed Omaha sample is optional.

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