Home phone:_________________ Cell phone:_________________

Work phone:_________________

Number of adults:_______ Number of children:_______ Number of pets:_______

What kind?_________

Applicant’s full name:___________________________________________________________________

Date of birth:_______________________

Social Security Number:______________________________

Current address:_______________________________________________________________________

Length of tenancy:___________________________

Rent amount:___________________________

Reason for moving:_____________________________________________________________________

Present landlord/Company name:_______________________________ Phone number:______________

Previous address:______________________________________________________________________

Length of tenancy:___________________________

Rent amount:___________________________

Reason for moving:_____________________________________________________________________

Previous landlord/Company name:______________________________

Phone number:_____________

Current employment:_____________________________ How long?__________

Income:__________

Other source of income:________________________________________________

Income:__________

Vehicle #1________________________________________________

License #_____________________

Vehicle #2________________________________________________

License #_____________________

Have you ever been convicted of or pleaded guilty or no contest to a felony, whether or not resulting in a

conviction? Yes_____ No_____

If yes, please explain: ___________________________________________________________________

Are you on the sex offender registry or scheduled to be on the sex offender registry? Yes_____ No_____

If yes, please explain:____________________________________________________________________

Have you ever been convicted of or pleaded guilty or no contest to a misdemeanor, other than traffic offenses, weather or not resulting in a conviction? Yes_____ No______

If yes, please explain:____________________________________________________________________

Have you ever been evicted or refused to pay rent when due? Yes_____ No_____

If yes, please explain:____________________________________________________________________

Do you have any outstanding monies owed to a landlord? Yes_____ No_____

If yes, please explain:____________________________________________________________________

The above information is true to the best of my knowledge. I give Chambers Management my permission to check into my credit history with CSC credit services and any person listed as reference or landlord. In the event that any adverse action is taken in regards to this application based wholly or in part to your credit, you may obtain a copy of your credit report by contacting: CSC Credit Services, 652 N. Sam Houston Parkway, Ste. # 325, Houston Texas, 77060, or you may call them at 1-800-759-5979.

_______________________________________

Applicant’s Signature

Application fee $10.00 _________