Free Apartment List Questionnaire
Second Chance Leasing Dallas/Houston Questionnaire www.secondchanceleasingdallas.com 
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1. What are the First & Last Current Legal Name/s of all adult/s over 18 going on your lease? *
2A. Email? *
2B. Cell Phone Number? *
Rental History and Background
3A. Do you have any broken leases? *
3B. What Month & Year did each broken lease happen? Please estimate. If no broken leases exist, please type none. *
3C. What is the amount owed on each broken lease? Please estimate. If no broken leases exist, please type none. *
4A. Do you have any evictions? *
4B. What Month & Year did each eviction happen? Please estimate. If no evictions exist, please type none. *
4C. What is the amount owed on each eviction? Please estimate. If no evictions exist, please type none. *
4D. Do you have any rental history since the broken lease or eviction? *
4E. How is your payment history with your current apartment? *
5. What is your credit score? (Optional, but important)
6. Please select all additional credit history information that applies. *
Required
7A. Felony or Misdemeanor? *
Required
7B. If criminal history exists, please list name of all charges, dates occurred, and probation status/length. If none, please type no charge. *
8. Additional 2nd chance comments-Please explain your situation here (Reason for broken lease or eviction, Cleaning fee/damages fee date/amount, bankruptcy open or close date, Utility debt fee/date, AD# interested in. If you don't have 2ndchance needs type "None" *
Employment/Income
9A. Current job length? *
9B. Household Monthly income? *
Apartment Areas Requested
Please select all of the specific areas/cities you want to live in from the 4 major rental markets below.
10 A. Metro Area *
10 B. Specific Areas- Cities, Suburbs and specific neighborhood areas. Please be sure to list at least 4-5 areas with names to receive a wide array of apartment options. *
11 A. What is your Max Price range needed? (If Section 8 Is needed, please mention in this box). Please be aware apartments require renters to make 3 times the rent. EX) Rent=$1000/month then Income=$3000/month *
11 B. What size apartment do you need? *
12. What is your exact move in date? *
How did you hear about us? *
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