Attached please find the lease application for:

1858 Hickory Creek Court, Acworth GA 30102 ___________________________________________________________________________ Property Address

One application and application fee of $45​ for each adult who will be living in the rental is required. Please follow all instructions completely and be as detailed as possible. ​Failure to do so will result in the delay of processing your application.​ Please provide us with the following information: 1. The names/ages of any minors who will be living in the home; 2. Information on your last 3 jobs (if applicable); 3. Information on your last 3 rentals/mortgages; 4. Three personal references; 5. Attach a photo ID; 6. The last 30 days worth of pay stubs. The application form will be completed and signed and all other documents will need to be faxed to the screening company directly. FOR THE PROTECTION OF YOUR PERSONAL AND FINANCIAL INFORMATION PLEASE DO NOT EMAIL THESE FORMS The screening company will use the credit card information you supply to process the app fee (each adult living in the home will pay the app fee - it is non-refundable and pays for the background search). PLEASE NOTE: The landlord does not accept any smokers or pets (with the exception of service or assistance animals - additional pet deposit may apply). Minimum credit score of 550 and ​criminal history background review will be completed. Past ​bankruptcies ​will be considered if dependable payment history since has been consistent. ​Applicants must make at least 3 x the monthly rent in monthly income. Thank you for applying and have a great day! Best regards,

Received and Acknowledged:

Steve Martin, Associate Broker PalmerHouse Properties ________________________________ Office: (404) 876-4901 Cell: (678) 913-3649 Email: [email protected]

________________________________ Applicant Signature(s) ________________________________ Date Signed

Tenant Screening Authorization Steve Martin PHP Associate: ________________________________________________________(Required) 678-913-3649 [email protected] PHP Associate Phone: _______________ PHP Associate Email: __________________________ APPLICANT: ___________________________________________________________________ 1858 Hickory Creek Court, Acworth GA 30102 PROPERTY ADDRESS: ____________________________________________________________ Attention Agents: This document must be accompanied by a GAR Form F44 - Rental Application Thank you for applying with Palmer House Properties Your rental application(s) will be processed by National Tenant Network. They will provide the landlord and PalmerHouse Properties with the background reports needed for the landlord to evaluate your rental application. The screening will include credit, nation-wide criminal, GA criminal, employment, eviction, and late payment checks. The cost to process your rental application is $45. If there are two related applicants or applicants who have lived or worked together previously, add $25. All other applicants are charged $45. These fees are paid by credit or debit card and are paid to National Tenant Network- Atlanta. Note that the creditor name appearing on your statement may be Bird Services Inc. or National Tenant Network. Money orders are also accepted, payable to National Tenant Network. I authorize Bird Services Inc. dba National Tenant Network to conduct an employment, landlord, credit, public and criminal records search on my background. I also authorize a charge of $________ to the credit/debit card below. This is a one-time charge to cover the cost of screening my rental application for the landlord and/or PalmerHouse Properties.

Signature: ____________________________________ Date:______/_______/_________ Name as it appears on card: ___________________________________________________ Billing address: __________________________________ ___________________________ City: ______________________________ State: ________________ Zip: _____________ Card type: ____Visa ____Mastercard ____American Express ____Discover Card Number: ______________________________________________________________ Expiration Date: ______/__________ *3 or 4 digit verification number: _______________ *American Express has 4 digits on the face… Visa, M/C, and Discover have 3 digits on the reverse

For Agent Use Only: Photo ID Presented: ____ Driver’s License: State of issue and number ___/______________________ ____Other Type of ID: ____/___________________________________________________________ I certify that I have viewed photo identification for this applicant. I also certify that I have viewed this credit card and that the information above is correct. Agent Name__________________________________________ GREC License #____________________ Agent Signature: __________________________________ Phone Number:_______________________ e-mail address_____________________________________

Agent should fax this completed credit card authorization AND a copy of the completed rental application to 770-517-3775 or scan/email documents to: [email protected] PalmerHouse Properties 2911 Piedmont Rd. NE Atlanta, GA 30305 O 404.876.4901 F 404.478.8495 www.palmerhouseproperties.com

AUTHORIZATION FOR RELEASE OF INFORMATION I hereby authorize Penny Smith (Home Owner) & PalmerHouse Properties ___________________________________________ and their agents to receive any CRIMINAL HISTORY record information pertaining

to me which may be in the files of any state, local or national criminal justice agency or repository. I release all parties from liability for damages for issuing such information in good faith. FULL NAME:

_____________________________________________________

SSN:

_______ - _____ - __________

ADDRESS:

_______________________________________ APT NO: ______

CITY:

________________________ STATE: _____

SIGNATURE:

__________________________________ DATE: ____________

ZIP: _________

The following information is required to insure an accurate match and used for no other purpose. SEX: _____ RACE: ______

DATE OF BIRTH: ____________

RENTAL APPLICATION (One For Each Adult Applicant)

2017 Printing

1858 Hickory Creek Court Application is hereby made to rent the premises generally described as ____________________________________________________ _____________________________________________________________________________________________________ (“Property”). Acworth GA 30102 5873291 The multiple listing service number for this property, if known, is ____________________________________________. 1. Lease Term. The term of the lease of the Property for which Applicant is applying shall start on ________________________________ (“Commencement Date”) and end on __________________________________.

$1,300 2. Proposed Monthly Rent. ___________________________________________ $45 per adult to NTN 3. Lease Application Fee. Applicant has paid a nonrefundable Lease Application Fee of $________________________________ to process this Rental Application, determine Applicant’s credit worthiness to lease the Property and conduct a background investigation of Applicant. 4. Authorization to Do Credit and Background Check. Applicant hereby authorizes Owner and any authorized agent of Owner (“Agent”) to do whatever background and credit check on Applicant that the Owner or Agent deem appropriate. This may include among other things obtaining one or more credit reports on Applicant. Such credit report(s) may be obtained before and during the term of the Lease and after the expiration or termination of the Lease as part of any effort to collect rent, costs, fees and charges owing under such Lease. Applicant acknowledges that merely requesting such reports may lower Applicant’s credit score and Applicant expressly consents to the same. 5. Reservation Fee. A reservation fee of $_______________________ by check, cash or money order is being made along with this rental application. If Applicant’s application is approved and a lease is entered into between Owner and Applicant the fee shall be applied towards Applicant’s rent as referenced in said lease. If Applicant’s application is denied, this Reservation Fee shall be refunded to Applicant without interest. If the Applicant’s application is approved, and Applicant fails to execute Owner’s standard lease agreement for the Premises prior to the Commencement Date (or to pay the required rent thereunder such that the lease does not Commence), then Owner may retain the Reservation Fee as liquidated damages, it being acknowledged and agreed that the same is a reasonable preestimate of Owner’s damages for not seeking to rent the Property to others during this time period and not a penalty. 6. Use of Information. The information in this application or obtained as a result of the authorization given herein by Applicant will not be sold or distributed to others. However, Owner or Agent may use such information to decide whether to lease the Property to Applicant and for all other purposes relative to any future lease agreement between the parties including the enforcement thereof. 7. Application Does Not Create a Lease. This application, even if accepted, shall under no circumstances be considered a lease agreement between Applicant and Owner or an offer to lease. No lease shall exist between Applicant and Owner unless and until the parties enter into a formal Lease Agreement and Applicant pays all required fees, deposits and advance rent. 8. Warranty of Applicant. Applicant hereby warrants that the information supplied above is complete and accurate and that the breach of this warranty by Applicant may result in the termination of any Lease entered into with Applicant by Owner. 9. Commitment to Equal Housing. Owner and Agent are committed to providing equal housing opportunities to all rental applicants regardless of race, color, religion, national origin, sex, handicap or familial status. 10. Reason for Denial. If this Application is denied, Owner or Agent shall within ten (10) days thereafter and upon the written request of applicant, state the basis for said denial to Applicant.

PalmerHouse Properties I, the undersigned, understand that _____________________________ (Broker/Management) is the Agent and representative for the owner of the Property and will be paid a fee by the owner. I also understand that this Property is being leased “AS-IS” in its present condition. I understand that Management prefers that I see the Property in person and conduct any inspections of the Property which I might desire, at my own expense, prior to applying for the Property. Accepted By: __________________________________________ __________________________________________ __________________________ Applicant’s Printed Name Signature Date

SAMUEL STEVE MARTIN IS INVOLVED AS A REAL ESTATE THIS FORM IS COPYRIGHTED AND MAY ONLY BE USED IN REAL ESTATE TRANSACTIONS IN WHICH _____________________________ LICENSEE. UNAUTHORIZED USE OF THE FORM MAY RESULT IN LEGAL SANCTIONS BEING BROUGHT AGAINST THE USER AND SHOULD BE REPORTED TO THE GEORGIA ASSOCIATION OF REALTORS® AT (770) 451-1831. Copyright© 2017 by Georgia Association of REALTORS®, Inc.

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I have visited the Property and had the opportunity to inspect it. I understand that I am accepting the Property "as is" except for any stipulations, changes or modifications that are listed as contingencies of this application. If any stipulations cannot be met, or an acceptable compromise agreed to by all parties, I understand that any fees I have paid with the submission of this Rental Application will be returned to me. I have not yet visited or seen the Property in person. Nor am I relying on any information, photos, or any other representations of the Agent through whom I learned of this Property except for information the Agent provided to me in writing. However I understand that if my application is approved, any fees I have paid with the submission of this Rental Application are non-refundable and any obligations under the lease I sign are fully enforceable. Having not viewed the Property will in no way be a reason for any refund or cancellation of the agreement. INFORMATION ABOUT APPLICANT. A. General First Name: ____________________________________ Middle _____________ Last Name: ______________________________________ SS #: ________________________________________ Date of Birth: _________________________________________________________ Driver's License #: __________________________________________ Driver’s License State: _____________________________________ Home Phone: ____________________________ Work: _______________________________ Cell: ________________________________ Email Address: ____________________________________________________________________________________________________ Emergency Contact Information: _______________________________________________________________________________________ Spouse/Significant Other Name (must fill out a separate application): __________________________________________________________ Names and ages of individuals under 18: ________________________________________________________________________________ Pets? YES

NO

What Kind? _______________________________________________ How Many? ___________________________

Pet Weights: ______________________________________________________________________________________________________ B. Residence History Current Address: ___________________________________________________________________________________________________ City/State/Zip: _____________________________________________________________________________________________________ How Long? __________________________________________ Current Lease Amount: $_________________________________________ Landlord Name: ______________________________________________ Phone #: ______________________________________________ Landlord Address: __________________________________________________________________________________________________ Reason for Leaving: ________________________________________________________________________________________________ Previous Address: __________________________________________________________________________________________________ City/State/Zip: _____________________________________________________________________________________________________ How Long? __________________________________________ Current Lease Amount: $_________________________________________ Previous Landlord Name: ___________________________________________ Phone #: _________________________________________ Previous Landlord Address: __________________________________________________________________________________________ Reason for Leaving: ________________________________________________________________________________________________

1858 Hickory Creek Court Address of Property_________________________________________________________________________________________________ Applicant’s Initials ___________________

SAMUEL STEVE MARTIN IS INVOLVED AS A REAL ESTATE THIS FORM IS COPYRIGHTED AND MAY ONLY BE USED IN REAL ESTATE TRANSACTIONS IN WHICH _____________________________ LICENSEE. UNAUTHORIZED USE OF THE FORM MAY RESULT IN LEGAL SANCTIONS BEING BROUGHT AGAINST THE USER AND SHOULD BE REPORTED TO THE GEORGIA ASSOCIATION OF REALTORS® AT (770) 451-1831. Copyright© 2017 by Georgia Association of REALTORS®, Inc.

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C. Employment Employer: __________________________________________________ Position: _______________________________________________ Employer Address: _________________________________________________________________________________________________ City/State/Zip: _____________________________________________________________________________________________________ Supervisor: _______________________________________________ Business Phone: __________________________________________ Length of Time at Present Job: __________________________________ Annual Income: ________________________________________ Previous Employer: __________________________________________________ Position: _____________________________________ Employer Address: _________________________________________________________________________________________________ City/State/Zip: _____________________________________________________________________________________________________ Supervisor: _______________________________________________ Business Phone: __________________________________________ Length of Time at Previous Job: ________________________________________ Income: ________________________________________ D. Other Matters Do you have a legal right to be in the United States? Yes, I am a U.S. Citizen Yes, I have valid documentation from the Bureau of Citizenship and Immigration Service No If you answered "YES" because you are a non-U.S. citizen with valid visa documentation, please provide: Reason you are in the US:_____________________________________________________________________________________ Visa Type:_____________________________________________ Visa Expiration Date: __________________________________

Have you ever been asked to move out of a residence?

Yes

No

Have you ever been party to an eviction?

Yes

No

Are you a registered sex offender?

Yes

No

Do you have liquid furniture? (i.e. waterbed)

Yes

No

Do you have renter insurance?

Yes

No

Have you ever filed bankruptcy?

Yes

No

Has bankruptcy been discharged or dismissed?

Yes

No

Have you ever had any debt collection actions against you?

Yes

No

1858 Hickory Creek Court Address of Property_________________________________________________________________________________________________ Applicant’s Initials ___________________

SAMUEL STEVE MARTIN IS INVOLVED AS A REAL ESTATE THIS FORM IS COPYRIGHTED AND MAY ONLY BE USED IN REAL ESTATE TRANSACTIONS IN WHICH _____________________________ LICENSEE. UNAUTHORIZED USE OF THE FORM MAY RESULT IN LEGAL SANCTIONS BEING BROUGHT AGAINST THE USER AND SHOULD BE REPORTED TO THE GEORGIA ASSOCIATION OF REALTORS® AT (770) 451-1831. Copyright© 2017 by Georgia Association of REALTORS®, Inc.

F44, Rental Application, Page 3 of 3, 01/01/17

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