Forms - Animal Questionnaire - Bullock Russell Dashboard

ANIMAL QUESTIONNAIRE

Applicant Name(Required)

First Last

Applicant Email Address(Required)

Name(s) of Co-Applicant(s) (if applicable)

Listing Agent Name Requesting this Form(Required)

First Last

Listing Agent's Email Address(Required)

Property Address for Rental Application ("Premises")(Required)

Street Address City

How many animals are you requesting permission to have on the Premises?(Required)

*If you have more than 5 animals that will be housed at the Premises, then please fill out additional forms until all animals have been listed.

Animal 1 Information

Animal 1: Please select the legal status of the animal(Required)

Pet

Emotional Support Animal, Qualified Support Animal, or Companion Animal

Qualified Service Animal

For the purposes of this question, "pet" refers to any domesticated animal kept for pleasure rather than utility. Service animals and emotional support animals are not considered pets.

Animal 1: Please specify the type of animal(Required)

Dog

Cat

Other

Animal 1: Age (yrs)(Required)

Animal 1: Weight (lbs.)(Required)

Animal 1: Please list your dog's breed(s).(Required)

If the dog is a mix, include every breed you know or reasonably suspect.

Animal 1: Insurance-Breed Check: To comply with insurance and liability requirements, please indicate whether your dog is—either wholly or in part—any of the breeds below.(Required)

Select all that apply, or choose “None of the above.”

Animal 1: Is your animal house broken?(Required)

Yes

Not applicable

Animal 1: Does your animal have a history of causing substantial property destruction?(Required)

Yes

Animal 1: Does your animal have a history of serious threatening behavior or a history of having caused harm to persons by biting, scratching, chewing or otherwise?(Required)

Yes

Animal 1: Is your animal properly licensed and vaccinated pursuant to applicable laws? Or if not, will your animal be properly licensed and vaccinated prior to the lease start date?(Required)

Yes

No, because there is no requirement under the law for this animal to be licensed and/or vaccinated.

Please upload a photo of the animal 1(Required)

Max. file size: 5 MB.

Reasonable Accommodation for Support Animal

If the Tenant Screening Policy provided to you does not allow for your animal, but you are requesting a reasonable accommodation to keep an emotional support animal, qualified support animal, or companion animal, and the need for that accommodation is not obvious, then you may be asked to provide written verification from a reliable third party (e.g., a medical professional, mental-health provider, or any other credible person with knowledge of your disability or disability-related need) that:

You have a disability as defined under the Americans with Disabilities Act, the Fair Housing Act, the Rehabilitation Act of 1973, the California Fair Employment and Housing Act, or the California Unruh Civil Rights Act.
The requested animal is necessary to afford you an equal opportunity to use and enjoy the dwelling.

Please note:

You do not have to disclose your specific diagnosis or detailed medical information—only enough to confirm that you have a disability and that there is a connection between your disability and the animal.
If your disability or need for this animal is readily apparent, we will not require documentation.

Please upload written verification letter for support animal 1(Required)

Max. file size: 5 MB.

Animal 2 Information

Animal 2: Please select the legal status of the animal(Required)

Pet

Emotional Support Animal, Qualified Support Animal, or Companion Animal

Qualified Service Animal

For the purposes of this question, "pet" refers to any domesticated animal kept for pleasure rather than utility. Service animals and emotional support animals are not considered pets.

Animal 2: Please specify the type of animal(Required)

Dog

Cat

Other

Animal 2: Age (yrs)(Required)

Animal 2: Weight (lbs.)(Required)

Animal 2: Please list your dog's breed(s).(Required)

If the dog is a mix, include every breed you know or reasonably suspect.

Animal 2: Insurance-Breed Check: To comply with insurance and liability requirements, please indicate whether your dog is—either wholly or in part—any of the breeds below.(Required)

Select all that apply, or choose “None of the above.”

Animal 2: Is your animal house broken?(Required)

Yes

Not applicable

Animal 2: Does your animal have a history of causing substantial property destruction?(Required)

Yes

Animal 2: Does your animal have a history of serious threatening behavior or a history of having caused harm to persons by biting, scratching, chewing or otherwise?(Required)

Yes

Animal 2: Is your animal properly licensed and vaccinated pursuant to applicable laws? Or if not, will your animal be properly licensed and vaccinated prior to the lease start date?(Required)

Yes

No, because there is no requirement under the law for this animal to be licensed and/or vaccinated.

Please upload a photo of the animal 2(Required)

Max. file size: 5 MB.

Reasonable Accommodation for Support Animal

You have a disability as defined under the Americans with Disabilities Act, the Fair Housing Act, the Rehabilitation Act of 1973, the California Fair Employment and Housing Act, or the California Unruh Civil Rights Act.
The requested animal is necessary to afford you an equal opportunity to use and enjoy the dwelling.

Please note:

You do not have to disclose your specific diagnosis or detailed medical information—only enough to confirm that you have a disability and that there is a connection between your disability and the animal.
If your disability or need for this animal is readily apparent, we will not require documentation.

Please upload written verification letter for support animal 2

Max. file size: 5 MB.

Animal 3 Information

Animal 3: Please select the legal status of the animal(Required)

Pet

Emotional Support Animal, Qualified Support Animal, or Companion Animal

Qualified Service Animal

For the purposes of this question, "pet" refers to any domesticated animal kept for pleasure rather than utility. Service animals and emotional support animals are not considered pets.

Animal 3: Please specify the type of animal(Required)

Dog

Cat

Other

Animal 3: Age (yrs)(Required)

Animal 3: Weight (lbs.)(Required)

Animal 3: Please list your dog's breed(s).(Required)

If the dog is a mix, include every breed you know or reasonably suspect.

Animal 3: Insurance-Breed Check: To comply with insurance and liability requirements, please indicate whether your dog is—either wholly or in part—any of the breeds below.(Required)

Select all that apply, or choose “None of the above.”

Animal 3: Is your animal house broken?(Required)

Yes

Not applicable

Animal 3: Does your animal have a history of causing substantial property destruction?(Required)

Yes

Animal 3: Does your animal have a history of serious threatening behavior or a history of having caused harm to persons by biting, scratching, chewing or otherwise?(Required)

Yes

Animal 3: Is your animal properly licensed and vaccinated pursuant to applicable laws? Or if not, will your animal be properly licensed and vaccinated prior to the lease start date?(Required)

Yes

No, because there is no requirement under the law for this animal to be licensed and/or vaccinated.

Please upload a photo of the animal 3(Required)

Max. file size: 5 MB.

Reasonable Accommodation for Support Animal

You have a disability as defined under the Americans with Disabilities Act, the Fair Housing Act, the Rehabilitation Act of 1973, the California Fair Employment and Housing Act, or the California Unruh Civil Rights Act.
The requested animal is necessary to afford you an equal opportunity to use and enjoy the dwelling.

Please note:

You do not have to disclose your specific diagnosis or detailed medical information—only enough to confirm that you have a disability and that there is a connection between your disability and the animal.
If your disability or need for this animal is readily apparent, we will not require documentation.

Please upload written verification letter for support animal 3(Required)

Max. file size: 5 MB.

Animal 4 Information

Animal 4: Please select the legal status of the animal(Required)

Pet

Emotional Support Animal, Qualified Support Animal, or Companion Animal

Qualified Service Animal

For the purposes of this question, "pet" refers to any domesticated animal kept for pleasure rather than utility. Service animals and emotional support animals are not considered pets.

Animal 4: Please specify the type of animal(Required)

Dog

Cat

Other

Animal 4: Age (yrs)(Required)

Animal 4: Weight (lbs.)(Required)

Animal 4: Please list your dog's breed(s).(Required)

If the dog is a mix, include every breed you know or reasonably suspect.

Animal 4: Insurance-Breed Check: To comply with insurance and liability requirements, please indicate whether your dog is—either wholly or in part—any of the breeds below.(Required)

Select all that apply, or choose “None of the above.”

Animal 4: Is your animal house broken?(Required)

Yes

Not applicable

Animal 4: Does your animal have a history of causing substantial property destruction?(Required)

Yes

Animal 4: Does your animal have a history of serious threatening behavior or a history of having caused harm to persons by biting, scratching, chewing or otherwise?(Required)

Yes

Animal 4: Is your animal properly licensed and vaccinated pursuant to applicable laws? Or if not, will your animal be properly licensed and vaccinated prior to the lease start date?(Required)

Yes

No, because there is no requirement under the law for this animal to be licensed and/or vaccinated.

Please upload a photo of the animal 4(Required)

Max. file size: 5 MB.

Reasonable Accommodation for Support Animal

You have a disability as defined under the Americans with Disabilities Act, the Fair Housing Act, the Rehabilitation Act of 1973, the California Fair Employment and Housing Act, or the California Unruh Civil Rights Act.
The requested animal is necessary to afford you an equal opportunity to use and enjoy the dwelling.

Please note:

You do not have to disclose your specific diagnosis or detailed medical information—only enough to confirm that you have a disability and that there is a connection between your disability and the animal.
If your disability or need for this animal is readily apparent, we will not require documentation.

Please upload written verification letter for support animal 4(Required)

Max. file size: 5 MB.

Animal 5 Information

Animal 5: Please select the legal status of the animal(Required)

Pet

Emotional Support Animal, Qualified Support Animal, or Companion Animal

Qualified Service Animal

For the purposes of this question, "pet" refers to any domesticated animal kept for pleasure rather than utility. Service animals and emotional support animals are not considered pets.

Animal 5: Please specify the type of animal(Required)

Dog

Cat

Other

Animal 5: Age (yrs)(Required)

Animal 5: Weight (lbs.)(Required)

Animal 5: Please list your dog's breed(s).(Required)

If the dog is a mix, include every breed you know or reasonably suspect.

Animal 5: Insurance-Breed Check: To comply with insurance and liability requirements, please indicate whether your dog is—either wholly or in part—any of the breeds below.(Required)

Select all that apply, or choose “None of the above.”

Animal 5: Is your animal house broken?(Required)

Yes

Not applicable

Animal 5: Does your animal have a history of causing substantial property destruction?(Required)

Yes

Animal 5: Does your animal have a history of serious threatening behavior or a history of having caused harm to persons by biting, scratching, chewing or otherwise?(Required)

Yes

Animal 5: Is your animal properly licensed and vaccinated pursuant to applicable laws? Or if not, will your animal be properly licensed and vaccinated prior to the lease start date?(Required)

Yes

No, because there is no requirement under the law for this animal to be licensed and/or vaccinated.

Please upload a photo of the animal 5(Required)

Max. file size: 5 MB.

Reasonable Accommodation for Support Animal

You have a disability as defined under the Americans with Disabilities Act, the Fair Housing Act, the Rehabilitation Act of 1973, the California Fair Employment and Housing Act, or the California Unruh Civil Rights Act.
The requested animal is necessary to afford you an equal opportunity to use and enjoy the dwelling.

Please note:

You do not have to disclose your specific diagnosis or detailed medical information—only enough to confirm that you have a disability and that there is a connection between your disability and the animal.
If your disability or need for this animal is readily apparent, we will not require documentation.

Please upload written verification letter for support animal 5(Required)

Max. file size: 5 MB.

Signature (Type Name)(Required)

By typing your name below, you are providing your electronic signature, which is legally binding and has the same validity as a handwritten signature.