PonderEI

APPLICATION – Residency/Lease Purchase/Sale/Rent

Applicant’s Details

Applicant’s Name

Home Phone No.

Cell No.

Present Address

Present Landlord

Landlord’s Phone No.

How Long Lived There?

Current Rent

Your Monthly Income

Employer

How Long?

Work Phone No.

Drivers License No.

D.O.B.

S.S. No.

Name of Bank

Approx. Value

Do you pay/receive child support?

Approx. amount paid/received

(circle paid or received) Emergency contact other than co-applicant

Relationship

Address

City/State

Phone

Co-Applicant’s Details

Co-Applicant’s Name

Phone No.

Present Address (if different from above)

Employer

How Long?

Monthly Income

Drivers License No.

D.O.B.

S.S. No.

List name, age and relationship of all other persons to be occupying premises (including children, relatives, and other co-residents):

Name

Age

Relationship

Name

Age

Relationship

Name

Age

Relationship

List ALL vehicles to be parked on the premises:

Will you have a pet?

Type

Have you or the Co-Applicant ever been evicted?

Have you or the Co-Applicant ever broken a rental agreement or lease contract?

Have you or the Co-Applicant ever been sued for non-payment of rent or damages to rental property?

Have you or the Co-Applicant ever been convicted of a felony?

Explain

Are you or anyone who will be residing with you, required by law to register as a sex offender?

AFFIRMATION OF INFORMATION AND AGREEMENT REGARDING FUNDS TO HOLD PREMISES Applicant(s) represent(s) that all of the above statements are true, complete and accurate. False information may constitute grounds for rejection of this application, termination of right of occupancy and/or forfeiture of any deposits, and may constitute a criminal offense under the laws of the State of Texas. Applicant hereby authorizes PEI, its affiliates and/or any person or entity PEI shall designate in its sole discretion to verify the foregoing information and all applicable credit and income information, whether through a credit report agency or through direct contact with employers, landlords or other individuals or entities. By signing below Applicant acknowledges that they are hereby informed of PEI’s rental selection criteria that includes factors such as criminal history, current income, and rental/credit history, and that none of such criteria is based upon any prohibited criteria, including but not limited to factors based on race, color, religion, gender, familial status, national origin and/or disability. ANY AMOUNT PAID BY APPLICANT PRIOR TO EXECUTING A LEASE AGREEMENT SHALL BE DEEMED TO BE AN APPLICATION FEE AND SHALL BE NON-REFUNDABLE IF APPLICANT FAILS TO SIGN A LEASE

X Applicant

X Co-Applicant

Date