BUSINESS INFORMATION

Full Legal Name: 

Dba: 

Business Address: 

Tel:  

Fax: 

Lease Under:   CORPORATION         PARTNERSHIP      INDIVIDUAL(S)

Years in Business:    

Person To Contact: 

Nature of Business: 

PLEASE LIST ALL BANK(S) (Business and Personal)

Name of Bank:     Branch:    Tel: 
Account Name:  Acct#:      Personal  Business

Name of Bank:     Branch:    Tel:    Account Name:   Acct#:      Personal   Business

TRADE REFERENCES, BUSINESS (If None, Personal)

Name of Company:    Tel: 

Address:        Personal    Business

Comments: 


Name of Company:  
Tel: 
Address:         Personal or  Business

Comments: 


Landlord´s Name:     Tel: 
Insurance Agency:    Tel: 
Address:    Agent: 

Comments:  
             Personal   Business  Auto

PERSONAL INFORMATION

Name:   Last:   First:  
Middle: 

Address: 
Previous Address (If Less Than 2 Years): 

Date of Birth:   Tel:   Fax: 

Driver´s License #:       Social Security #: 

Spouse´s Name:   Date of Birth:

Driver´s License #:    Social Security #:

Vehicles (all to be parked on premises): 

Emergency Contact Name:  Tel: 

List All Occupants:

Have You Ever Filed For Bankruptcy?

Personal:          Yes     No       When: 

Business:          Yes      No      When: 

Have any of the applicants or occupants listed above ever been: convicted of a felony, received deferred adjudication for a felony, been evicted, broken a lease or declared bankruptcy? If yes, please explain. 
 

The above listed applicant declares that all statements made in this application are true and complete.  Applicant hereby authorizes TCI Properties to verify all of the information in this application and obtain credit report(s) on the above listed applicant and/or applicants.  If applicant or applicant´s spouse has given any false information, Landlord is entitled to reject application and retain all application fees as liquidated damages for Landlord´s time and expenses in processing this application.