Lease Application

Each occupant and co-applicant 18 years or older must submit a separate application.

Property Address

Street Address Address Line 2 City State ZIP Code

Anticipated Move-In Date

Monthly Rent ($)

Security Deposit ($)

Initial Lease Term Requested (Months)

A. Applicant Identification

Applicant's Name (as listed on proof of identification)

Applicant's Former Last Name (if applicable)

Email

Mobile Ph.

Work Ph.

Home Ph.

Do you consent to receiving text messages?

Yes

No

Soc. Sec. No.

Driver License/ID No.

in (State)

Date of Birth

Height

Weight

Eye Color

Hair Color

Are there co-applicants?

Yes

No

Note: If yes, each co-applicant must submit a separate application.

Co-applicant's name

Relationship

Co-applicant's name

Relationship

Co-applicant's name

Relationship

B. Property Condition

Has the applicant viewed the Property in-person prior to submitting any application?

Yes

No

Applicant is strongly encouraged to view the property in-person prior to submitting any application.

Landlord makes no express or implied warranties as to the Property's condition. Applicant requests Landlord consider the following repairs or treatments should Applicant and Landlord enter into a lease:

C. Representation and Marketing

Is Applicant represented by a REALTOR® or other agent?

Yes

No

If yes, Name

Company

Email

Phone Number

Applicant was made aware of Property via:

Sign

Internet

Other

D. Applicant Information

Housing:

Applicant's Current Address

Street Address Address Line 2 City State ZIP Code

Landlord or Property Manager's Name

First Last

Email

Phone (Day)

Phone (Night)

Mobile

Fax

Move In Date

Move Out Date

Rent ($)

Reason for move

Applicant's Previous Address

Street Address Address Line 2 City State ZIP Code

Landlord or Property Manager's Name

First Last

Email

Phone (Day)

Phone (Night)

Mobile

Fax

Move Out Date

Move In Date

Rent ($)

Reason for move

Employment and Other Income:

Applicant's Current Employer

Address

Street Address Address Line 2 City State ZIP Code

Employment Verification Contact

First Last

Phone

Fax

Email

Start Date

Gross Monthly Income

Position

Note: If Applicant is self-employed, Landlord may require one or more previous year's tax return attested by a CPA, attorney, or other tax professional.

Applicant's Previous Employer

Address

Street Address Address Line 2 City State ZIP Code

Employment Verification Contact

First Last

Phone

Fax

Email

Employed From

Employed To

Gross Monthly Income ($)

Position

Note: Applicant is responsible for including the appropriate contact information for employment verification purposes.

Describe other income Applicant wants considered:

Emergency Contact:

Emergency Contact Name

First Last

Relationship

Address

Street Address Address Line 2 City State ZIP Code

Phone

Email

I. Authorization:

Applicant authorizes Landlord and Landlord's authorized agent, at any time before, during, or after any tenancy, to:

(1) obtain a copy of Applicant's credit report;
(2) obtain a criminal background check related to Applicant and any occupant; and
(3) verify any rental or employment history or verify any other information related to this application with persons knowledgeable of such information.

Notice of Landlord's Right to Continue to Show the Property: Unless Landlord and Applicant enter into a separate written agreement otherwise, the Property remains on the market until a lease is signed by all parties and Landlord may continue to show the Property to other prospective tenants and accept another offer.

Privacy Policy: Landlord's agent or property manager maintains a privacy policy that is available upon request.

Fees: Applicant submits the non-refundable fee shown below (entity or individual) for processing and reviewing this application.

Non-refundable fee from ($)

Non-refundable fee to ($)

Will the Applicant submit an application deposit to be applied to the security deposit upon execution of a lease or returned to Applicant if a lease is not executed?

Yes, the Applicant will submit an application deposit

No, the Applicant will not submit an application deposit

Please enter the application deposit amount ($):

Acknowledgement & Representation:

(1) Signing this application indicates that Applicant has had the opportunity to review Landlord's tenant selection criteria, which is available upon request. The tenant selection criteria may include factors such as criminal history, credit history, current income, and rental history.
(2) Applicant understands that providing inaccurate or incomplete information is grounds for rejection of this application and forfeiture of any application fee and may be grounds to declare Applicant in breach of any lease the Applicant may sign.
(3) Applicant represents that the statements in this application are true and complete.
(4) Applicant is responsible for any costs associated with obtaining information.

Applicant's Signature*

Date

AUTHORIZATION TO RELEASE INFORMATION RELATED TO A RESIDENTIAL LEASE APPLICANT

I,

First Last

(Applicant), have submitted an application to lease a property located at:

Address

Street Address Address Line 2 City State ZIP Code

The landlord, broker, or landlord's representative is:

Top of Texas Real Estate, LLC
219 E. 7th Street, P.O. Box 352
Dalhart, TX 79022
(806)244-6000
cyndi@topoftexasrealestate.com

I give my permission:

(1) to my current and former employers to release any information about my employment history and income history to the above-named person;
(2) to my current and former landlords to release any information about my rental history to the above-named person;
(3) to my current and former mortgage lenders on property that I own or have owned to release any information about my mortgage payment history to the above-named person;
(4) to my bank, savings and loan, or credit union to provide a verification of funds that I have on deposit to the above-named person; and
(5) to the above-named person to obtain a copy of my consumer report (credit report) from any consumer reporting agency and to obtain background information about me.

Applicant's Signature*

Date

Note: Any broker gathering information about an applicant acts under specific instructions to verify some or all of the information described in this authorization. The broker maintains a privacy policy which is available upon request.

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