Received on (date) at (time)
RESIDENTIAL LEASE APPLICATION
USE OF THIS FORM BY PERSONS WHO ARE NOT MEMBERS OF THE TEXAS ASSOCIATION OF REALTORS®, INC. IS NOT AUTHORIZED.
©Texas Association of REALTORS®, Inc. 2018
Each occupant and co-applicant 18 years or older must submit a separate application.
Property Address:
Anticipated: Move-in Date: Monthly Rent: $ Security Deposit: $
Initial Lease Term Requested: (months)
Property Condition: Applicant is strongly encouraged to view the Property 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:
Applicant was referred to Landlord by:
Real estate agent (name) (phone) (e-mail)
Newspaper Sign Internet Other
Applicant's name (first, middle, last)
Is there a co-applicant? yes no If yes, co-applicant must submit a separate application.
Applicant's former last name (maiden or married)
E-mail Home Phone
Work Phone Mobile/Pager
Soc. Sec. No. __________________________ Driver License No. ___________________________ in (state)
Date of Birth Height Weight Eye Color
Hair Color Marital Status Citizenship (country)
Emergency Contact: (Do not insert the name of an occupant or co-applicant.)
Name:
Address:
Phone: E-mail:
Name all other persons who will occupy the Property:
Name: Relationship: Age:
Name: Relationship: Age:
Name: Relationship: Age:
Name: Relationship: Age:
Applicant's Current Address: Apt. No.
(city, state, zip)
Landlord or Property Manager's Name: Email:
Phone: Day: Nt: Mb: Fax:
Date Moved-In: Move-Out Date Rent $
Reason for move:
Applicant's Previous Address: Apt. No.
(city, state, zip)
Landlord or Property Manager's Name: Email:
Phone: Day: Nt: Mb: Fax:
(TXR-2003) 2-1-18 Page 1 of 4
Crowned Eagle Realty, 8627 Cinnamon Creek #302 San Antonio, TX 78240 Phone: 210.426.3000 Fax: 210.4263014 ...
Daniel Kubinski Produced with zipForm® by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026 www.zipLogix.com
Residential Lease Application concerning
Date Moved-In Move-Out Date Rent $
Reason for move:
Applicant's Current Employer:
Address: (street, city, state, zip)
Supervisor's Name: Phone: Fax:
E-mail:
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, city, state, zip)
Supervisor's Name: Phone: Fax:
E-mail:
Employed from to Gross Monthly Income: $ Position:
Describe other income Applicant wants considered:
List all vehicles to be parked on the Property:
Type Year Make Model License Plate No./State Mo.Pymnt.
Will any pets (dogs, cats, birds, reptiles, fish, and other pets) be kept on the Property? yes no
If yes, list all pets to be kept on the Property:
Rabies
Type & Breed Name Color Weight Age in Yrs. Gender Neutered? Declawed? Shots Current? Bite History?
Y N Y N Y N Y N
Y N Y N Y N Y N
Y N Y N Y N Y N
Y N Y N Y N Y N
Yes No
Will any waterbeds or water-filled furniture be on the Property?
Does anyone who will occupy the Property smoke?
Will Applicant maintain renter's insurance?
Is Applicant or Applicant's spouse, even if separated, in military?
If yes, is the military person serving under orders limiting the military person's stay to one
year or less?
Has Applicant ever:
been evicted?
been asked to move out by a landlord?
breached a lease or rental agreement?
filed for bankruptcy?
lost property in a foreclosure?
had any credit problems, including any outstanding debt (e.g., student loans or medical bills),
slow-pays or delinquencies?
been convicted of a crime? If yes, provide the location, year, and type of conviction below.
Is any occupant a registered sex offender? If yes, provide the location, year, and type of
conviction below.
Is there additional information Applicant wants considered?
(TXR-2003) 2-1-18 Page 2 of 4
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Residential Lease Application concerning
Additional comments:
Authorization: Applicant authorizes Landlord and Landlord's 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 a non-refundable fee of $ to
(entity or individual) for processing and reviewing this application. Applicant submits will not submit an application
deposit of $ to be applied to the security deposit upon execution of a lease or returned to Applicant if a
lease is not executed.
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.
Applicant's Signature Date
For Landlord's Use:
On , (name/initials) notified
Applicant by phone mail e-mail fax in person that Applicant was
approved not approved. Reason for disapproval:
(TXR-2003) 2-1-18 Page 3 of 4
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Residential Lease Application concerning
AUTHORIZATION TO RELEASE INFORMATION
RELATED TO A RESIDENTIAL LEASE APPLICANT
USE OF THIS FORM BY PERSONS WHO ARE NOT MEMBERS OF THE TEXAS ASSOCIATION OF REALTORS®, INC. IS NOT AUTHORIZED.
©Texas Association of REALTORS®, Inc. 2018
I, (Applicant), have submitted an application
to lease a property located at
(address, city, state, zip).
The landlord, broker, or landlord's representative is:
(name)
(address)
(city, state, zip)
(phone) (fax)
(e-mail)
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.
(TXR-2003) 2-1-18 Page 4 of 4
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