NEBRASKA LANDORD TENANT FORMS

APPLICATION FOR NEW TENANTS

The undersigned, in support of their application for rental of ____________________________________, North Platte, Nebraska, authorizes LANDLORD, its employees and agents to make inquiry of any of the individuals named in this application to include a background check with any credit reporting agency and authorizes the release of any and all information from any of the individuals named in this application together with any records of any credit reporting agency.

Name of Applicant(s): Date of Birth:__________________________________________________
Social Security #________________________________________________
Address:

Last three (3) previous addresses:

1.

Landlord and Landlord’s address:

Name:
Address: 
Period of time at above address:

2.
Name:
Address: 
Period of time at above address:

3. Name:
Address:

Period of time at above address:

Number of children . Names and Ages:


Employer:
Name:
Address:
How long employed:
Previous employer:
Length of employment:
Name of Banking Institution:

Dated this ______________ day of _____________________________, 20___.



Signed:
Applicant

Signed:
Applicant





LEASE AGREEMENT

THIS AGREEMENT made and entered into on the ________ day of _________________________, 20____, between LANDLORD, hereinafter referred to as "Lessor", and (LESSEE), hereinafter referred to as "Lessee", "Lessor" leases to "Lessee" the premises situated at 2001 Adams Street, in the City of North Platte, State of Nebraska, together with all appurtenances, on a monthly basis, commencing on the _____________ day of ___________________, 20___ for a period of ______________ months.

RENT
"Lessee" agrees to pay, without demand, to "Lessor" as rent for the demised premises the sum of $______________ per month in advance on the first day of each calendar month. The first month’s lease payment shall be due upon the signing of this lease and a like payment to be made on the first day of each month thereafter for the entire term of this lease. Said payments shall be mailed to "Lessor" at 6001 Baker Street, North Platte, NE, 69101.

SECURITY DEPOSIT
CHECK ONE
( )Upon the execution of this Lease, "Lessee" shall also deposit with "Lessor" an additional $_____________ as security for the faithful performance by "Lessee" of the terms hereof, and for payment of all damages sustained by the property while in "Lessee's" possession, to be returned to "Lessee", without interest, upon the full and faithful performance by "Lessee" of the provisions hereof and return of the property in the condition which it is in on the date hereof.

( ) Within _______ days of the execution of this Lease, "Lessee" shall deposit with "Lessor" an additional $_____________ as security for the faithful performance by "Lessee" of the terms hereof, and for payment of all damages sustained by the property while in "Lessee's" possession, to be returned to "Lessee", without interest, upon the full and faithful performance by "Lessee" of the provisions hereof and return of the property in the condition which it is in on the date hereof.

UTILITIES
"Lessee" shall be responsible for arranging for and paying for all utility services required on the premises as of the date this lease commences.


ALTERATIONS AND IMPROVEMENTS
"Lessee" shall make no alterations to the buildings on the demised premises or construct any buildings or make other improvements on the demised premises without the prior written consent of "Lessor."

ASSIGNMENT AND SUBLETTING
"Lessee" shall not assign this lease, or sublet or grant any concession for license to use the premises or any part thereof without the prior written consent of "Lessor."
“Lessee” will use the premises for residential purposes only.

MAINTENANCE
"Lessee" is solely responsible for maintenance to the premises during the term of this Lease. "Lessee" shall be responsible for keeping and maintaining the premises in a clean and tenantable condition including regular mowing, watering, and maintenance of the lawn and clearing the sidewalk and any driveways from ice, snow, and debris.
“Lessor” is responsible for the control of insect or animal infestation. “Lessee” is responsible for taking care of sporadic insect or varmint control on a day to day basis.
“Lessee” is responsible for day to day routine maintenance of air conditioning and heating units, including the changing of filters on a regular basis.

PETS
No pets will be allowed, unless approved by “Lessor” and “Lessee” agrees to pay an additional pet deposit.

LOUD PARTIES
No loud parties will be tolerated.

FIRE OR CASUALTY DAMAGE & RENTERS INSURANCE
"Lessor" hereby covenants for "Lessee" quiet enjoyment of said premises during the term of this Lease Agreement, and that if said premises shall be injured by fire or other cause, without fault or neglect of "Lessee", or their agents, servants, or employees so as to render said premises or any part thereof untenantable, a proportionate part of the rent reserved herein shall be abated until again made tenantable. In the event of a partial destruction of said premises during the term of this Lease Agreement, from any cause not the fault or neglect of "Lessee" as aforesaid, "Lessor" shall forthwith repair the same provided said repairs can be made within forty-five (45) days, but such partial destruction shall, in no way, annul or void this Lease, except that the "Lessee" shall be entitled to a proportionate deduction to be based upon the extent to which the making of such repairs shall interfere with the enjoyment of the premises by "Lessee." If such repairs cannot be made within forty-five (45) days or such repairs cannot be made under local ordinances, this Lease may be terminated at the option of either party. A total destruction of the premises shall terminate this Lease.
“Lessee” is responsible for maintaining a renter’s insurance policy covering the personal property of the “Lessee.”

DISCLOSURE OF INFORMATION
LEAD-BASED PAINT AND LEAD-BASED PAINT HAZARDS
Housing built before 1978 may contain lead-based paint. Lead from paint, paint chips, and dust can pose health hazards if not taken care of properly. Lead exposure is especially harmful to young children and pregnant women. Before renting pre-1978 housing, landlords must disclose the presence of known lead-based paint and lead-based paint hazards in the dwelling. Tenants must also receive a federally approved pamphlet on lead poisoning prevention.
“Lessor” has no knowledge of lead-based paint and/or lead-based paint hazards in the housing.
“Lessor” has no reports or records pertaining to lead-based paint and/or lead-based paint hazards in the housing.
“Lessee” acknowledges receipt of the federally approved pamphlet on lead poisoning and reading the above and foregoing disclosure by signing this lease.

CONDITION
Upon termination of this Lease Agreement, "Lessee" agrees to return the premises to "Lessor" in the same condition that the premises exists on the date of the execution of this Agreement.
Upon termination of this Lease Agreement, “Lessee” is expected to have the carpets professionally cleaned before leaving the premises.

INSPECTIONS
Upon reasonable notice (twenty-four hours) to “Lessee,” “Lessor” may inspect the premises for damage or disrepair, and have the premises repaired or cleaned at the “Lessee’s” expense.


DEFAULT & LATE FEES
Rent shall be due on the first day of each month. If rent due is not received by "Lessor" by the fifth day of each month, "Lessee" shall be in default and a late fee of $50.00 shall be owed by “Lessee” to “Lessor” for each month rent is paid after the fifth day of the month for which it is due. If any default is made in the payment of rent or late fees, or any part thereof, or if any default is made in the performance of or compliance with any other term or condition hereof, the Lease, at the option of "Lessor", shall terminate and be forfeited, and "Lessor" may re-enter the premises and remove all persons therefrom, or, in the alternative, "Lessor" may exercise any remedy available at law or in equity to "Lessors" in Nebraska on default or breach by "Lessee", including forcible entry and detainer. Also, any failure to remove or evict "Lessee" upon non-payment of rent or other default shall not in any way be construed as a waiver of any future breach or default on "Lessee's" part.

TERMINATION
This lease shall automatically terminate on the last day of the last month of its term, unless otherwise terminated by the parties. If the “Lessee” remains on the premises as a paying tenant after the term of this lease, then and in that event all provisions of this lease shall continue to bind “Lessee” except that the term shall convert to a month to month tenancy and the rent may be raised at the option of “Lessor.”

BINDING
The covenants and conditions herein contained shall apply to and bind the heirs, legal representatives, and assigns of the parties hereto, and all covenants are to be construed as conditions of this lease.

The parties have executed this lease at North Platte, Lincoln County, Nebraska, on the day and year first above written.

Before signing this agreement, “Lessee” may contact “Lessor’s” attorneys BROUILLETTE LAW OFFICE, PC, LLO, ATTORNEYS AT LAW, at (308) 532-1600 or an attorney of “Lessee’s” choice with any questions about the above and foregoing agreement.


LESSOR:


________________________________
LANDLORD

LESSEE:


________________________________

Printed Name:___________________


________________________________










THREE DAY NOTICE OF TERMINATION OF LEASE AGREEMENT
FOR NON-PAYMENT OF RENT


TO: TENANT

ADDRESS: 2001 Adams Street
North Platte, NE 69101

YOU ARE HEREBY NOTIFIED that you have failed to pay rent for the month of April, 2002, on the property located at 2001 Adams Street, North Platte, Nebraska, according to your written rental agreement. The total amount due and owing, including late fees of $20.00 is $370.00.
YOU ARE FURTHER NOTIFIED that if this rent is not paid in full within three (3) days from the date of the receipt of this Notice, the rental agreement for the above-described premises will terminate and you shall be required to vacate the premises immediately. If you then fail to vacate the premises, a lawsuit may be brought against you for (1) return of the premises; (2) rent and other damages; and, (3) costs and attorney fees to the extent allowed by law.
DATED this _____ day of __________, 20__.
Landlord,



By_______________________________
Timothy P. Brouillette
FOR: BROUILLETTE LAW OFFICE, P.C., LLO
P.O. Box 1605
North Platte, NE 69103-1605
(308) 532-1600

ATTORNEYS FOR LANDLORD

PROOF OF SERVICE

I certify that I served a copy of the above and foregoing Notice on the individuals

named above by:

_____ Hand delivery on this _____ day of _________, 20___, or by

__X_ United States first class mail, addressed as set forth above this 12th day of April, 20____, or by

_____ Posting such notice upon the door of the premises on this _____ day of __________, 20___.

_________________________________
Timothy P. Brouillette