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TILL PROPERTY MANAGEMENT LLC P O Box 1134 Anahuac, TX 77514 490.267.1003 RENTAL APPLICATION Applicant’s
Full Name:___________________________ Phone Number:___________Mailing Address:________________________________________________________Physical Address:_______________________________________________________DL State/Number:_________________ SS#:________________
Date of Birth:___Marital Status:
___Single ___Married ___Widowed ___
Separated Race:_________________ How Did you hear about us?________________________ Why are you moving?____________________________________________________ Have you given your present landlord notice of your intent to relocate?______________
YOUR
SPOUSE OR CO-TENANT Full Name: _____________________________________
Phone Number:__________Mailing
Address:________________________________________________________Physical Address:_______________________________________________________DL State/Number:_________________ SS#:________________ Date of Birth:_____________________Marital Status: ___Single___Married___Widowed
___ Separated Race:_________________ Why are you moving?____________________________________________________ RENTAL HISTORY Current Landlord:______________________________________________________________________________
Phone number:____________Addresss:______________________________________________________________ How long did you live there? _____________
Monthly rent:________________ Previous Landlord:_____________________________________________________________________________ Phone Number:_________Addresss:______________________________________________________________ How long did you live there? _____________
Monthly rent:________________ OTHER OCCUPANTS Name:_______________________________ Age:______ Date of Birth:___________SS Number:____________ DL Number/State:_____________
Relationship:_________Name:_______________________________
Age:______ Date of Birth:___________SS Number:____________ DL Number/State:_____________ Relationship:_________ Name:_______________________________ Age:______ Date
of Birth:___________SS Number:____________
DL Number/State:_____________ Relationship:_________ VEHICLES Make & Model:__________________________________ Year:__________________Color:__________________ License
Plate #:_________________Make &
Model:__________________________________ Year:__________________Color:__________________ License Plate #:_________________
FAMILY REFERENCES Name:_______________________________________Phone:__________________Address:___________________ Name______________________________________Phone:__________________Address:_____________________ Name:_______________________________________Phone:__________________Address:___________________ Name:_______________________________________Phone:__________________Address:___________________ NON-RELATED
REFERENCES Name:___________________________________________________
Phone:__________________Address:_________________________________________ Name:_______________________________________ Phone: __________________Address:______________________________________________________________
EMERGENCY
CONTACT Name:_________________________________ Relationship:____________________Address:_______________________________________________________________Day Phone Number:___________________ Evening
Phone Number:______________ Do you authorize the above
named person to take possession of your property in case of serious illness, death or disappearance? ____YES ____
NO/If no please list who to release it to:___________________________________________________________Are we authorized to release any monies due you to the above named persons?______If no please list who to release it to:__________________________________________ GENERAL INFORMATION Does anyone in your household have a criminal record besides traffic fines?_________ Please describe:________________________________________________________ Does anyone in your household use or sale drugs, or been arrested for drugs?_______ Has anyone in your household been convicted of a felony or received deferred adjudication?
If so explain:________________________________________________ Has anyone in your household been arrested or convicted as a sex offender? If so explain:_______________________________________________________________ Has anyone in your household previously rented from PLB or Till Property, Inc?____________If so when & reason for leaving:____________________________________________ Has anyone in your household ever done any of the following? If
so when & where:
Broken
a lease agreement?__________________________________________ Been evicted?_____________________________________________________ Been sued for damages or non-payment for previous residency? ___________ CREDIT/BANKING
REFERENCES Company:_____________________________________________
Phone Number:_____________ Acct#___________Address:_______________________________________________________________ Company:_____________________________________________ Phone Number:_____________ Acct#___________Address:_______________________________________________________________ Bank:_______________________________________________________ Phone
Number:_____________ Acct
#___________Address:_______________________________________________________________
INCOME INFORMATION Applicant’s
Employer:__________________________________________________________________ Phone Number:_____________Address:____________________________________ Monthly Net Wages:_________ Spouse/Co-Tenant’s Employer:__________________________________________________________
Phone
Number:_____________Address:____________________________________
Monthly
Net Wages:_________ Social Security Income:_________________
Child Support/Alimony:______________ Other Income:__________________________________________________________
CERTIFICATION
& SIGNATURES I/WE certify that all statements made on this
application are true and correct. I/WE authorize the owner or its representative to contact any person
listed on the application to verify any information contained herein. I/WE further understand that if any
information found to be false or incorrect that my/our application may be rejected. I/WE also certify that
the unit being applied for will be my/our permanent residence and will not hold a separate unit in a different location.
I/WE further understand that there is a $25.00 application fee payable at the time application is made.
I/WE also understand that by signing this application I/WE give my/our permission to the owner or its representatives
to run a criminal background check and/or credit report.Applicants Signature:___________________________________
Date:____________ Spouse/Co-Applicant Signature:__________________________
Date:____________ Co-Applicant Signature:_________________________________
Date:____________ Co-Applicant Signature:_________________________________
Date:____________
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