New Client Registration

First Name

Last Name

Current Address

City

State

Zip

Primary Phone

Landlord Name

Landlord Phone

Agent

OPTIONAL: Choose a password and access your profile on our website.

Password

Confirm Password

Desired Locations

Desired Size

Budget –

Must Have Amenities

Do you have any Pets?

No Yes

Describe your pets

When must you move by?

How long have you been searching?

Special Requirements?

Employer

Years at Job?

Annual Salary

Job Title

Office Phone

How is your credit?

If necessary, do you have access to a Guarantor to co-sign your lease?

No Yes

Guarantor's Name

Residence

Income

Relantionship

I understand there is no fee for registering. Should I lease a residence in a building or complex shown to me within 90 days of such showing, I agree to pay a commission of 15% of one year's rent or 1 months rent depending upon what was agreed upon. This commission is earned and payable when I sign a lease and/or the landlord gives its approval for said residence. If there is any issue with collecting the brokers fee and it has to be litigated in court, the fee will be 15% plus any legal fees accrued.

I Accept the terms & conditions of this agreement

Client Signature

Clear