Emit Moss Trust

P.O Box 23787

Houston, TX 77228

713-491-0040 or

281-543-0387

Personal Information

Tenant 1 Name______

Present Address ______

Phone #______Driver License______State______

Date of Birth______Social Security #______

Tenant2Name______

Phone # ______Driver License ______State______

Date of Birth______Social Security #______

Occupants/Children

Occupant’s Name ______Relationship______

Occupant’s Name ______Relationship______

Occupant’s Name ______Relationship______

Rental History

Present Address ______

Date of Occupancy______Rent Paid $ ______

Landlord Name ______Landlord Phone ______

Previous Address______

Date of Occupancy______Rent Paid $ ______

Landlord Name ______Landlord Phone ______

Employment History

Tenant 1 Employer______Supervisor ______Phone #______Position ______Length of Employment ______Annual Income ______

Tenant 2Employer______Supervisor ______Phone #______

Position ______Length of Employment ______Annual Income______

RENTAL APPLICATION

(please print)

Emergency Contact (Relative or Friend)

Name______Relationship ______Home Phone # ______Address______City / State / Zip ______Work Phone #______

References

(Employer or co-worker)

1. Name ______Relationship: ______

Cell: ______Email: ______

(Relative)

2. Name ______Relationship: ______

Cell: ______Email: ______

(Friend)

3. Name ______Relationship: ______

Cell: ______Email: ______

(Friend or Relative)

4. Name ______Relationship: ______

Cell: ______Email: ______

E-mail Address: ______

How did you hear about us? ______

If resident referral, please give name: ______

Do you have any pets? YES / NO If yes, please note there is a $250 non-refundable Pet Fee

Type of Pet: ______Number of Pet: ______

Have you ever filed bankruptcy YES / NO

Have you ever been evicted? YES / NO If yes, When?______

Have you ever been convicted of a felony or have any criminal record? YES / NOIf yes, When?______

_____ Tenant is responsible for all utilities, gas, water, sewage which includes deposits.

_____ Tenant may not make changes to the property without the consent of the owner in writing.

Property will be inspected prior to moving and at any time designated by the property owner.

_____Tenant may not keep any pet on the Property unless specifically authorized by this agreement and has paid a pet fee.

“Pet” includes any animal, whether mammal, reptile, bird, fish, rodent, or insect. Tenant can only have 2 pets per household. The tenant must keep the shots of any pet current. Tenant is responsible and liable for: any damage to the Property or any item in the Property caused by any pet; any personal injuries to any person caused by any pet; and any damage to any person’s property caused by any pet. Tenant will protect, defend, indemnify, and hold Landlord, Landlord’s property manager, and Landlord’s agents harmless from any damages, costs, attorney’s fees, and expenses that are caused by the act of any pet or Tenant.Tenant must remove or confine any pet(s) at any time that the pet is likely to limit or prohibit Landlord or other persons access to Property.

_____ Tenant is aware that after 5 days of delinquency (lateness of rent) anEviction process will begin with all expenses assumed by the tenant. To avoid removal from the property the tenant will have to pay ALL late fees, eviction expenses and rent due. If there is any reason the rent cannot be paid; please contact Moss Properties at 713-491-0040. Business hours are 9:00 am – 5:00 pm Monday through Friday. If you have major work continually done it could cause an increase in your rent. We recommend tenant should secure renter’s insurance; the owner will not be liable for damages due to act of negligence of occupant, employees, patrons, visitors, or due to unauthorized repair(s). All maintenance should be reported within 24 hours of problem(s).

_____ We will not accept personal checks;we only accept money order or cashier’s check. Make your money order or cashier’s check payable to EMMIT MOSS TRUST, PO BOX 23787, HOUSTON TX 77228

Signatures/Authorization

I hereby certify that the information I have provided above is truthful and complete. I understand that any false or inaccurate information on my application could result in the denial of my application. I agree to pay a non-refundable move in fee in the amount of $500.00 and if applicable a non-refundable pet fee of $250.00 for each pet.

Tenant 1 Signature______Date______

Tenant 2 Signature______Date______

Office Use Only

Application Taken By: ______Date______Application Fee: _____No Application Fee Required_____

Date: ______Approved / Denied / Cancelled Notified of Approval/Denied: ______

Rental Move in Fee Required _$500.00______Rental Move in Fee Received ______Date______

Pet Fee Required _$250.00______Pet Fee Received ______Date______