Alan B. Cash - Real Estate Direct - Secure Rental Application

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The Form Below Is Encrypted With 256-Bit Encryption For Your Protection

Click Here For a BRIEF Printable Application That You Can Fill Out and Mail or Fax

Or Fill Out the Form Below and Submit it Directly to Us on Our Secure Web Server.

Or Just Call Us at
817-238-0000 .

Renter's Information

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Renter's First and Last Name:

Renter's Address

City, State and Zip Code:

E-mail Address:

Daytime Phone with Area Code:

Evening Phone with Area Code:

Cell Phone with Area Code:

Do you Currently Own or Rent?

Own
Rent

How Long at Your Current Address?

How Long On Your Current Job?

Total Monthly Income Before Taxes

Please Note: Alimony, child support, or separate maintenance income need not be revealed if you do not wish it to be considered as a basis for making rental payments.

If You Know Your Credit Score Enter It Here

Date of Birth

Social Security Number

Co-Rneter's Information (Husband, Wife, Friend or Relative)

Co-Renter's First and Last Name:

Co-Renter's Address

City, State and Zip Code:

E-mail Address:

Daytime Phone with Area Code:

Evening Phone with Area Code:

Cell Phone with Area Code:

Do you Currently Own or Rent?

Own
Rent

How Long at Your Current Address?

How Long On Your Current Job?

Total Monthly Income Before Taxes

Please Note: Alimony, child support, or separate maintenance income need not be revealed if you do not wish it to be considered as a basis for making rental payments

If You Know Your Credit Score Enter It Here

Date of Birth

Social Security Number

Authorization

Thank you for choosing Alan B. Cash - Real Estate Direct for your real estate needs. Please read and agree to the following before you click on "Submit". I/we hereby authorize Alan B. Cash - Real Estate Direct, or designee, to obtain a consumer credit report for the purpose of pre-qualifying me/us for a home rental. This information is to determine if I/we qualify for a home rental with no warranty of approval guaranteed or implied. To obtain formal, written, unconditional approval, a formal, written loan application must be completed with the landlord and must be processed and underwritten to the landlord's guidelines. Privacy Act Notice: The information to be obtained will be used by Alan B. Cash - Real Estate Direct, or its designee to determine whether you qualify as a prospective tenant under the landlord's underwriting standards. The information will not be disclosed outside the landlord without your consent except for the person or company verifying the information including, but not limited to, employer, and any other credit reference as needed to verify other credit information as permitted by law. You do not have to give us this information, but if you elect not to, your application may be delayed or rejected for lack of information. You may fill in this form on line and then print the form to send by mail or fax. (Please call 817-238-0000 for our fax number or mailing address) ---- OR ---- You may electronically sign the form and submit it directly via E-Mail by clicking on the "Submit" button below This information will be delivered by our 128 bit encrypted secure web server.

Renter Signature (enter name if online)	Co-Renter Signature (enter name if online)

Renter Signature Date	Co-Renter Signature Date

Other Notes or Comments
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