Lease Application

Referred By:
Property you are applying for:*
Personal Information
Full Name:*
DOB:*
Email:*
License #:*
State*
Home Phone:*
Work Phone:
Marital Status:*
Spouse Information
Full Name:*
DOB:*
Email:
License #:
State
Home Phone:*
Work Phone:
General Information
How many people will occupy the unit?*
List their name(s), age(s) & relationship(s) to you:
Do you have any pets?*
- No
- Yes
How many?
What size and type?
Have you or your spouse ever declared bankruptcy?*
- No
- Yes
Have you or your spouse ever been convicted of a felony?*
- No
- Yes
List all Vehicles to be parked on the premises by any potential resident of unit:
In case of emergency notify (full name):*
Home Phone:*
Work Phone:
Relationship:*
Lease History
Your Present Address:*
Street Address City State ZIP Code
Name of Property Manager:
Phone:
Have you or your spouse ever been evicted?
- No
- Yes
Have you or your spouse ever been sued for nonpayment of rent or damages to property?*
- No
- Yes
Employment History
Applicant’s Employer:
Phone:
How Long?
Monthly Income:
Position:
Applicant’s Former Employer:
Phone:
How Long?
Monthly Income:
Position:
Spouse’s Employer:
Phone:
How Long?
Monthly Income:
Position:
Credit References
Please list all credit references:
The undersigned persons represent that all the above statements are true and complete and hereby authorize verification of such information via credit reports, rental history reports, rental history reports.
Full Name:*
Today's Date:*
BASIC LICENSEE DUTIES
Jay T. Rembe, Broker

As per §16.61.19.8 of the New Mexico Real Estate License Law, real estate licensees are obligated to make you aware of the following list of duties that are owed to all customers and clients, prior to presenting any written document that has the potential of becoming an express written agreement. Please acknowledge your receipt of this list by signing below.

(1) Honesty and reasonable care; as set forth in the provisions of this document;

(2) Compliance with local, state, and federal fair housing and anti-discrimination laws, the New Mexico Real Estate License Law and the Real Estate Commission Rules and Regulations, and other applicable local, state, and federal laws and regulations;

(3) Performance of any and all oral or written agreements made with the Licensee's Customer or Client;

(4) Assistance to the Licensee's Customer or Client in completing the Transaction, unless otherwise agreed to in writing by the Customer or Client, including:
A. Presentation of all offers or counter-offers in a timely manner;
B. Assistance in complying with the terms and conditions of a purchase agreement and with the closing of the Transaction, or in the case of a lease, the consummation of the Lease agreement;
If the Licensee in a Transaction is not expected to provide the service, advice or assistance described in paragraphs 4 A and B, the Customer or Client must agree in writing that the Licensee is not expected to provide such service, advice or assistance, and the Licensee shall disclose such agreement in writing to the other Licensees involved in the Transaction;

(5) Acknowledgment by the Licensee that there may be matters related to the Transaction that are outside the Licensee's knowledge or expertise and that the Licensee will suggest that the Customer or Client seek expert advice on these matters;

(6) Prompt accounting for all monies or property received by the Licensee;

(7) Prior to the time the Licensee generates or presents any written document that has the potential to become an Express Written Agreement, written disclosure of (a) any written Brokerage Relationship the Licensee has with any other Parties to the Transaction and/or (b) any material interest or relationship of a business, personal, or family nature that the Licensee has in the Transaction;

(8) Disclosure of any adverse material facts actually known by the Licensee about the property or the Transaction, or about the financial ability of the Parties to the Transaction to complete the Transaction. Adverse material facts do not include data from a sex offender registry or the existence of group homes;

(9) Maintenance of any confidential information learned in the course of any prior Agency relationship unless the disclosure is with the former Client's consent or is required by law; and

(10) Unless otherwise authorized in writing, a Licensee shall not disclose to its Customer or Client during the transaction that their seller client or customer has previously indicated they will accept a sales price less than the asking or listed price of a property; that their buyer client or customer has previously indicated they will pay a sales price greater than the price submitted in a written offer; the motivation of any party for selling or buying property; that their seller client or customer or their buyer client or customer will agree to financing terms other than those offered; or any other information requested in writing by the Licensee's Customer or Client to remain confidential, unless disclosure is required by law.
Acknowledged By:*
Date:*
Time:*
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Lease Application

Personal Information

Spouse Information

General Information

Lease History

Employment History

Credit References