| RENTAL/CRIMINAL HISTORY INFORMATION |
| Have you or any occupant listed on this application ever ... |
| been evicted or been asked to move out? |
broken a rental agreement? |
declared bankruptcy? |
been sued for rent? |
| been evicted or been asked to move out? |
been arrested for a felony, misdemeanor, or sex-related crime that was resolved by conviction, probation, deferred adjudication, court-ordered community supervision, or pretrial diversion?** |
| ** Please indicate below the year, name of the Court, and type of each felony, misdemeanor, and sex-related crime other than those resolved by dismissal or acquittal. We may need additional information before accepting you as a resident. (You represent the answer "No" to any item not checked above.) |
| EMERGENCY CONTACT INFORMATION |
| In case of emergency, contact: |
Relationship |
Address : City : State : Zip : |
Phone (with Area Code): |
| In case of emergency, contact: |
Relationship |
Address : City : State : Zip : |
Phone (with Area Code): |
| In case of emergency, contact: |
Relationship |
Address : City : State : Zip : |
Phone (with Area Code): |
| I certify that, to the best of my knowledge, all statements are true and complete. I further authorize Landlord to obtain credit reports, criminal/character reports, rental history, and employment/income verification, as necessary, to confirm all information in the above-referenced application. |