BuySellorRentAHome.Com - National Real Estate Services

Application

List Applicants

	Name	SSN	Email	Cell	Work
Applicant
Co-Applicant

* Email Address of person submitting application:

* Property Needs:

	Rent Range	Deposit	Down Payment	Move Date	Length of Contract	City/State
$

* Applicant Address:

	Current Address	City, State, Zip	Home Phone
Applicant
Co-Applicant

* Identification

	Date of Birth	Drivers License #	State Issued
Applicant
Co-Applicant

* Marital Status: Applicant

Marital Status: Co-Applicant

* Employment Status

Employment Status: Co-Applicant

Tell us about your Employment/Income:

	Who is your employer?	What is your position? How Long?	Who is your supervisor?	What is your annual income?
Applicant
Co-Applicant

Other Income:

	Amount	Frequency	Source
Applicant
Co-Applicant

We offer all possible options in your home search.

Select the type of Contract you are seeking:

Tell us about yourself and those who will occupy the home:

* NUMBER OF OCCUPANTS

List Occupants:

	Name	Relationship	Birth Date	Work/School Phone
Yourself
Spouse
Other
Other
Other

* Please reply to each question below:

	Yes	No	Explain: Dates, Status, Pet Description, Etc
Do you have pets?
Have you ever been evicted?
Have you ever filed bankruptcy?
Do you or other occupants smoke?
Do you have water filled furniture?
Have you ever been convicted of a felony?

List cars:

	Year	Make	Model	Color
Car 1
Car 2
Car 3
Car 4

Rental History

* Current Address:

* Dates Lived at This Address:

* Reason for leaving:

Please provide landlord information:

	Name	Phone	Fax	Email
Current
Previous

Tell us about the home you are seeking

Indicate the number, description or yes/no to the following details:

	Required	Prefer	No Preference
Bedrooms
Bathrooms
Bonus Room
Office
Dining Room
Garage
Fenced Yard
Private Lot
School
Area/Community
Single Family Home
Condo/Townhome
Apartment
Duplex

We will prepare for your tour of properties as your schedule permits

When are you available to view properties?

	Date	Time	How Long
1st Choice
2nd Choice
3rd Choice

Please share your search experience with us:

It helps us to know about your search experience, we are constantly striving to serve you better!

	Internet Search:	Referred By:	Other site link:	Comments:
How did you hear about us?
How did you find our site?
Were you referred by a friend?
Were you referred by a agency/agent?
What other sites have you found helpful?
Have you viewed properties of interest?

Additional Questions or Comments:

* Applicant authorizes the owner/agent to contact past and present landlords, employers, creditors, credit bureau, neighbors and any other sources deemed necessary to investigate applicant. All the information is true, accurate and complete to the best of applicant's knowledge. Owner/Agency reserves the right to disqualify tenant if information is not as represented. ANY PERSON OR FIRM IS AUTHORIZED TO RELEASE INFORMATION ABOUT THE UNDERSIGNED UPON PRESENTATION OF THIS FORM OR A PHOTOCOPY OF THIS FORM AT ANY TIME. I agree to accept National Real Estate Services as my Exclusive Relocation Agent to contact owners of homes on my behalf. If I choose another property on my own or I choose a property where the owner does not agree to pay the lease acquisition fee, I agree to pay National real esate Services a fee equal to 1 month rent. If I elect to purchase a property, I will inform the agent/owner that National Real Estate services and it's associated companies is my relocation agent, where a referral fee is paid by the agent/owner at no additional expense to me.

Agree

Disagree

* I submit my signature below to authorize the contract terms as stated herein. Submitting a false identity will be reported to all proper authorities.

* Indicates Response Required

	Yes	No	Question or Request for Information
Lease
Purchase
Owner Finance
Lease Purchase
Lease with Option