LAWLER DEVELOPMENT GROUP, LLC

Rental Application
Separate application required from each applicant age 18 or older.
THIS SECTION TO BE COMPLETED BY LAWLER DEVELOPMENT GROUP, LLC
Address of Property to be Rented:_____________________________________________
Rental Term: ___month-to-month or ___lease from ________________to ____________
Rental Rate for this property:__________________ per month
Amounts Due Prior to Occupancy
First month's rent.................................................$__________________
Security deposit...................................................$__________________
Prorated amount of first months rent.................. $__________________
TOTAL...............$__________________

THIS SECTION TO BE COMPLETED BY APPLICANT

Full Name-include all names you use(d): __________________________________
Home Phone: ____________________ Work Phone: _____________________
Cell Phone: _____________________ Email: __________________________
FAX: ________________________ (by providing this fax number I agree to receive facsimile
advertisements from the landlord or management company.)
Social Security Number: ________________________________________________
Drivers License Number/State: __________________________________________
Other Identifying Information: ___________________________________________
Vehicle Make: __________ Model: __________ Color: __________ Year: ________
License Plate Number/State: _____________________________________________
Additional Occupants
List everyone, including children, who will live with you:
Full Name
Relationship to Applicant
______________________________
______________________________
______________________________
______________________________
______________________________
______________________________
______________________________
______________________________
Rental History
Current Address: _____________________________________________________
_____________________________________________________
Dates Lived at Address: ________________ Reason for Leaving: ________________
Landlord/Manager: ___________________ Landlord/Manager's Phone: __________
Rent: $_____________________________ Security Deposit: $_________________

Previous Address: _____________________________________________________

_____________________________________________________
Dates Lived at Address: ________________ Reason for Leaving: ________________
Landlord/Manager: ___________________ Landlord/Manager's Phone: __________
Rent: $_____________________________ Security Deposit: $_________________
Previous Address: _____________________________________________________
_____________________________________________________
Dates Lived at Address: ________________ Reason for Leaving: ________________
Landlord/Manager: ___________________ Landlord/Manager's Phone: __________
Rent: $_____________________________ Security Deposit: $_________________

If you are a student:

Who will pay your rent?___________________ Relationship to you____________________
If your parents will be paying rent, do they guarantee this?____________________________
Parents home phone:________________ Parent's cell phone__________________________
Parent's work phone:________________

If you are employed:

Self-employed applicants: attach tax returns for the past two years.
Name and Address of Current Employer: __________________________________
__________________________________
Phone: ________________________________
Name of Supervisor: ____________________ Supervisor's Phone: _____________
Dates Employed at This Job: ______________Position or Title: _______________
Name and Address of Previous Employer: __________________________________
__________________________________
Phone: ________________________________
Name of Supervisor: ____________________ Supervisor's Phone: _____________
Dates Employed at This Job: ______________Position or Title: _______________
Attach pay stubs for the past two years, from this employer or prior employers.
Income
1. Your gross monthly employment income (before deductions): $__________
2. Average monthly amounts of other income (specify sources): $__________
_____________________________________________________________________
_____________________________________________________________________
TOTAL: $__________

Loans
Type of Loan

Name of
Creditor

Account
Number

Amount Owed

Monthly
Payment

______________

___________

____________

__________ ____________

______________

___________

____________

__________ ____________

______________

___________

____________

__________ ____________

Other Major Obligations

Type
Payee

Amount Owed

______________

______________

____________

____________

______________

______________

____________

____________

______________

______________

____________

____________

Monthly Payment

Miscellaneous
Describe water-filled furniture you want to have in the rental property:
_____________________________________________________________________
Do you smoke? [ ] yes

[ ] no

Have you ever: Filed for bankruptcy? [ ] yes [ ] no

How many times _____

Been sued?

[ ] yes [ ] no

How many times _____

Sued someone else?

[ ] yes [ ] no

How many times _____

Been evicted?

[ ] yes [ ] no

How many times _____

Been convicted of a
crime?

[ ] yes [ ] no

How many times _____

Explain any "yes" listed above: ___________________________________________

References and Emergency Contact
Personal Reference: ______________________ Relationship: ________________
Address: _______________________________
_______________________________
Phone: ____________________________
Personal Reference: ______________________ Relationship: __________________
Address: _______________________________
_______________________________
Phone: ____________________________

Contact in Emergency: ____________________ Relationship: __________________

Address: _______________________________
_______________________________
Phone: ____________________________
Source
Where did you learn of this vacancy? ______________________________
PLEASE INITIAL THE FOLLOWING:
The address of the property is:________________________________________________ _________
I understand that no pets are allowed. No exceptions._________
I understand that no smoking is allowed. No exceptions._________
I understand the no tenants or their guests may go onto the roof. No exceptions._________
I understand that if the lease consists of more than one person, all members are jointly responsible for
the rent payment and all other terms of the lease._________
I understand that if one roommate moves or defaults, the others become totally responsible for the rent
and terms of the lease._________
I understand that the security deposit is not to be used as first or last month's rent._________
I understand that each applicant must fill out an application and that each applicant will be placed on
the lease._________
I understand that any and all fireplaces located on the property will be closed off and inoperable and I
agree that they are to remain closed off and inoperable._________
I understand that if my parents will be paying rent that they will need to sign a cosigner
agreement. I understand that if this application results in the signing of a lease (before the cosigner
agreement is received) that Lawler Development Group, LLC is relying on receipt of a completed
copy of this agreement from my parents. If this cosigner agreement is not received in a reasonable
amount of time then I fully understand that Lawler Development Group, LLC, and only Lawler
Development Group, LLC, shall have the option to terminate my lease and my right to enter into
possession of the premises._________
I understand that the rental property listed at the beginning of this agreement was built before 1978 and,
therefore, may contain lead-based paint. I acknowledge that I have received, reviewed and understand
the Lead-Based Paint Disclosure Form and that this form was completely executed by Lawler
Development Group, LLC and myself before the signing of the lease. I also acknowledge that I have
received the pamphlet Protect Your Family From Lead In Your Home before the signing of the
lease._________

I understand that I will be solely responsible for the insuring of my personal property against any risk
of damage, destruction, or loss from theft, fire, storm, or any other hazard. Regardless of whether I
secure such insurance and regardless of the cause, Lawler Development Group, LLC or its agents shall
not be liable for any damage to, or destruction or loss of, any of my personal property. Whatever the
cause, I, my family, my guests, my invitees (whether expressed or implied) agree to release, indemnify,
defend and hold Lawler Development Group, LLC. and its agents harmless from any and all claims or
assertions of every kind and nature, including, but not limited to, liability for injury resulting from any
cause.__________
I certify that I am of legal age and that all of the information contained in the rental application is true
and complete. I understand that my lease or rental agreement may be terminated if I have made any
material false or incomplete statements in this application. I authorize verification of the information
provided in this application from my credit sources, current and previous landlords and employers, and
personal references. I give permission for Lawler Development Group, LLC to obtain a consumer
report about me for the purpose of this application, to ensure that I continue to meet the terms of the
tenancy, for the collection and recovery of any financial obligations relating to my tenancy, or for any
other permissible purpose. I also understand that the following "Addendum to Rental Application" is
attached to this application and is, therefore, made a part of this application.

_______________________________________________
Name (please print)
________________________________________________

__________________

Signature

Date

Notes (Lawler Development Group, LLC)

___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
________________________________________________

LAWLER DEVELOPMENT GROUP, LLC

ADDENDUM TO RENTAL APPLICATION

1. LEASE AGREEMENT: The lease agreement for this property is joint and several which means
that each person signing the lease will be responsible for the total rent due.

2. NOTICE OF NONRENEWAL OF LEASE: Either party [Lawler Development Group, LLC or

tenant(s)] must give at least 60 days notice of nonrenewal of lease in the the form of a written letter.
To be clear, notification may be given long before this 60 days.

3. PETS: No pets are allowed. No exceptions.

4. SMOKING: No smoking is allowed. No exceptions.
5. NO ACCESS: No tenants or their guests will be allowed access to the roof. No exceptions.
6. INSURANCE: The tenant shall be solely responsible for insuring any of his personal property
located or stored upon the Premises. Therefore, we highly recommend that you obtain renters
insurance which can be purchased at a nominal cost through most insurance agents.

7. POSSESSION INFORMATION: Lawler Development Group, LLC shall not be liable for any
delay in possession of the premises due to causes beyond their direct control.

8. LEAD BASED PAINT DISCLOSURE: A completely executed disclosure form (signed by all
applicants) will be required with your rental application and is attached.

PLEASE INITIAL BELOW ACKNOWLEDGING YOU HAVE READ AND UNDERSTAND THIS
ADDENDUM TO RENTAL APPLICATION:
Initial(s)___________________
Initial(s)___________________
Initial(s)___________________
Initial(s)___________________
Initial(s)___________________
Initial(s)__________________

Lead-Based Paint Disclosure Form

Lead Warning Statement:
Housing built before 1978 may contain lead-based paint. Lead from paint, paint chips, and dust can pose health hazards if
not managed properly. Lead exposure is especially harmful to young children and pregnant women. Before renting pre-1978
housing, lessors must disclose the presence of known lead-based paint and/or lead-based paint hazards in the dwelling.
Lessees must also receive a federally approved pamphlet on lead poisoning prevention.
Timing of Disclosure:
The parties agree that this Lead-Based Paint Disclosure Form was executed before the Lessee was obligated under any
contract to lease.
Lessors Disclosure:
(a) Presence of lead based paint and/or lead based paint hazards:
____ (i) Known lead-based paint and/or lead-based paint hazards are present in the housing.
_X_ (ii) Lessor has no knowledge of lead-based paint and/or lead-based paint hazards in the housing.
(b) Records and reports available to the lessor:
____ (i) Lessor has provided the lessee with all available records and reports pertaining to lead-based paint
and/or lead-based paint hazards in the housing (list documents below)
_X_ (ii) Lessor has no reports or records pertaining to lead-based paint and/or lead-based paint hazards in the
housing.
Lessees Acknowledgement (INITIAL NEXT TO (c) & (d))
(c) ______ ______ Lessee has received copies of all information listed above.
______ ______
______ ______
(d)______ ______ Lessee has received the pamphlet Protect Your Family
______ ______ From Lead In Your Home.
______ ______
Certification of Accuracy
The following parties have reviewed the information above and certify, to the best of their
knowledge, that the information they have provided is true and accurate.
LESSEE:
LESSOR: Lawler Development Group, LLC
______________________________________________
Lessee (sign and PRINT name)
Date

___________________________________
Daniel Lawler (managing member)
Date

______________________________________________
Lessee (sign and PRINT name)
Date

___________________________________
Leslie Jarrett Lawler (member)
Date

______________________________________________
Lessee (sign and PRINT name)
Date
______________________________________________
Lessee (sign and PRINT name)
Date
______________________________________________
Lessee (sign and PRINT name)
Date
______________________________________________
Lessee (sign and PRINT name)

Date

Consent to Contact References and Perform Credit Check

I authorize Lawler Development Group, LLC to obtain information about me from my credit sources,
current and previous landlords, employers, and personal references, to enable Lawler Development
Group, LLC to evaluate my rental application.
I give permission for the landlord or its agent to obtain a consumer report about me for the purpose
of this application, to ensure that I continue to meet the terms of the tenancy, for the collection and
recovery of any financial obligations relating to my tenancy, or for any other permissible purpose.
__________________________
Applicant signature
Printed name: ______________________
Address: _________________________
_________________________
Phone Number: ____________________
Date: _________________