Residential Lease Application



©Texas Association of REALTORS®, Inc. 2014

Each occupant and co-applicant 18 years or older must submit a separate application.

Information About Brokerage Services

Texas law requires all real estate license holders to give the following information about
brokerage services to prospective buyers, tenants, sellers and landlords.


  • A BROKER is responsible for all brokerage activities, including acts performed by sales agents sponsored by the broker.
  • A SALES AGENT must be sponsored by a broker and works with clients on behalf of the broker.

A BROKER’S MINIMUM DUTIES REQUIRED BY LAW (A client is the person or party that the broker represents):

  • Put the interests of the client above all others, including the broker’s own interests;
  • Inform the client of any material information about the property or transaction received by the broker;
  • Answer the client’s questions and present any offer to or counter-offer from the client; and
  • Treat all parties to a real estate transaction honestly and fairly.


AS AGENT FOR OWNER (SELLER/LANDLORD): The broker becomes the property owner’s agent through an agreement with the owner, usually in a written listing to sell or property management agreement. An owner’s agent must perform the broker’s minimum duties above and must inform the owner of any material information about the property or transaction known by the agent, including information disclosed to the agent or subagent by the buyer or buyer’s agent.

AS AGENT FOR BUYER/TENANT: The broker becomes the buyer/tenant’s agent by agreeing to represent the buyer, usually through a written representation agreement. A buyer’s agent must perform the broker’s minimum duties above and must inform the buyer of any material information about the property or transaction known by the agent, including information disclosed to the agent by the seller or seller’s agent.

AS AGENT FOR BOTH – INTERMEDIARY: To act as an intermediary between the parties the broker must first obtain the written agreement of each party to the transaction. The written agreement must state who will pay the broker and, in conspicuous bold or underlined print, set forth the broker’s obligations as an intermediary. A broker who acts as an intermediary:

  • Must treat all parties to the transaction impartially and fairly;
  • May, with the parties’ written consent, appoint a different license holder associated with the broker to each party (owner and buyer) to communicate with, provide opinions and advice to, and carry out the instructions of each party to the transaction.
  • Must not, unless specifically authorized in writing to do so by the party, disclose:
    • that the owner will accept a price less than the written asking price;
    • that the buyer/tenant will pay a price greater than the price submitted in a written offer; and
    • any confidential information or any other information that a party specifically instructs the broker in writing not to disclose, unless required to do so by law.

AS SUBAGENT: A license holder acts as a subagent when aiding a buyer in a transaction without an agreement to represent the  buyer. A subagent can assist the buyer but does not represent the buyer and must place the interests of the owner first.


  • The broker’s duties and responsibilities to you, and your obligations under the representation agreement.
  • Who will pay the broker for services provided to you, when payment will be made and how the payment will be calculated.

LICENSE HOLDER CONTACT INFORMATION: This notice is being provided for information purposes. It does not create an obligation for  you to use the broker’s services. Please acknowledge receipt of this notice below and retain a copy for your records.

Licensed Broker / Broker Firm Name or Primary Assumed Business Name: Mickey Lavy

License No.: 274617


Phone: 254-776-3090


Sales Agent/Associate’s Name: Amber Stephens

License No.: 721005


Phone: 254-776-3090


Buyer/Tenant Initials:  

Seller/Landlord Initials: _____________


Property Address:

Anticipated Move-in Date:

Monthly Rent: $

Security Deposit: $

Applicant was referred to Landlord by:


Applicant’s name (first, middle, last)

Is there a co-applicant?

If yes, co-applicant must submit a separate application.

Applicant’s former last name (maiden or married)


Home Phone

Work Phone


Date of Birth



Eye Color

Hair Color

Marital Status

Citizenship   (country)

Emergency Contact: (Do not insert the name of an occupant or co-applicant.)



    Phone: Email:

Name all other persons who will occupy the Property:

Name:  Relationship:  Age:

Name:  Relationship: Age:

Name:    Relationship:  Age:

Name:     Relationship:  Age:

Applicant’s Current Address: Apt. Number:

  (City, State, Zip)

   Landlord or Property Manager’s Name: 


   Phone:Day: Nt: Mb: Fax:

   Date Moved-In:  Move-Out Date:  Rent $:

   Reason for move:

Applicant’s Previous Address: Apt. Number:

(City, State, Zip)

   Previous Landlord or Property Managers Name:  Email: 

   Phone:Day: Nt: Mb: Fax

   Date Moved-In:  Date Moved Out:  Rent $:

   Reason for move: 

Applicant’s Current Employer: 

   Address: (street, city, state, zip)

   Supervisor’s Name: Phone: Fax: 


   Start Date:  Gross Monthly Income: $ Position: 

     Note: If Applicant is self-employed, Landlord may require one or more previous year’s tax return attested by a CPA, attorney, or other tax professional.

Applicant’s Previous Employer: 

   Address: (street, city, state, zip)

   Supervisor’s Name: Phone:  Fax:


   Employed from:   to: Gross Monthly Income: $ Position:

Describe other income Applicant wants considered:

List all vehicles to be parked on the Property:

Type, Year, Make, Model, License/State, Mo. Pymnt.


Will any pets (dogs, cats, birds, reptiles, fish and other pets) be kept on the Property?

Type & Breed, Name, Color, Weight, Age in Yrs., Gender

Does anyone who will occupy the Property smoke?

Is Applicant or Applicant’s spouse, even if separated, in military?

If yes, is the military person serving under orders limiting the military person’s stay to one year or less?

Has Applicant ever:

been evicted?

been asked to move out by a landlord?

breached a lease or rental agreement?

filed for bankruptcy?

lost property in a foreclosure?

had any credit problems (including any outstanding debt (e.g., student loans or medical bills)), slow-pays or delinquencies?

been convicted of a crime?

Is any occupant a registered sex offender?

Are there any criminal matters pending against any occupant?

Is there additional information Applicant wants considered?

Additional comments:


Upon receipt of your completed application, someone from our office will contact you to verify your social security and driver license numbers. Please make sure that all contact information is correct so that we may speak with you directly.


Authorization:     Applicant authorizes Landlord and Landlord’s agent, at any time before, during, or after any tenancy, to:

          (1) obtain a copy of Applicant’s credit report;

          (2) obtain a criminal background check related to Applicant and any occupant; and

          (3) verify any rental or employment history or verify any other information related to this application with persons knowledgeable of such information.

Notice of Landlord’s Right to Continue to Show Property:  Unless Landlord and Applicant enter into a separate written agreement otherwise, the Property remains on the market until a lease is signed by all parties and Landlord may continue to show the Property to other prospective tenants and accept another offer.

Privacy Policy:  Landlord’s agent or property manager maintains a privacy policy that is available upon request.

Fees: Applicant submits a non-refundable fee of $ to (entity or individual) for processing and reviewing this application. Applicant

$ to be applied to the security deposit upon execution of a lease or returned to Applicant if a lease is not executed.

Acknowledgement & Representation:

(1)    Signing this application indicates that Applicant has had the opportunity to review Landlord’s tenant selection criteria, which is available upon request. The tenant selection criteria may include factors such as criminal history, credit history, current income and rental history.
(2)    Applicant understands that providing inaccurate or incomplete information is grounds for rejection of this application and forfeiture of any application fee and may be grounds to declare Applicant in breach of any lease the Applicant may sign.
(3)    Applicant represents that the statements in this application are true and complete.



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Bluebonnet Properties/Bluebonnet, Realtors® - Property Management & Real Estate in Waco, Texas
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Document name: Residential Lease Application
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November 8, 2018 11:21 am CSTResidential Lease Application Uploaded by Amber Stephens - IP