Supplemental Rental Application
for Non-U.S. Citizens
Each co-resident and each occupant over 18 who is not a U.S. citizen
must submit a separate application.
We are requesting you to fill out this Supplemental Rental Application because you have indicated that you are not a U.S. citizen. We are asking all applicants
who are not U.S. citizens to fill out this form. We are committed to compliance with fair housing laws and do not discriminate based on race, color, religion,
sex, national origin, handicap or familial status. The purpose of this form is:
1. to give you the option to furnish information about an emergency contact person for you in your home country;
2. to verify that you are lawfully in the United States;
3. to determine whether your right to be in the U.S. expires during your Lease Contract term; and
4. to enable us to better cooperate with government officials in the performance of their duties, when requested.
We don’t anticipate sharing this Supplemental Application with anyone except government officials who might inquire about you.
ABOUT YOU Your full name (exactly as your name appears on any identi- Please check the U.S. Citizenship and Immigration Services (USCIS)
fication card or document issued by U.S. Citizenship and Immigration Services): document that entitles you to be in the United States:
Evelyn Rosibeth Alvarez Zelaya
_____________________________________________________________ r Form I-485 (Application to Register Permanent Residence
or Adjust Status) Case number: ______________________________
Country or countries of which you are a citizen (list all): _______________ r Form I-94 Arrival-Departure Record (form does not include photo or fin-
El Salvador
_____________________________________________________________ gerprint). Expiration date: ___________________________________
_____________________________________________________________ Form number: ____________________________________________
r Other official USCIS document (describe in detail): _______________
Approximately how long have you been in the United States? _________________________________________________________
15
Years: ___________ 4
Months: ___________ r USCIS receipt for replacement of one of the above documents, with
verification by USCIS of your entitlement to the document.
Have you ever been found removable under the laws of the U.S. or any
If you are relying on an immigration status document without a photograph,
other country? r Yes r No If yes, please state when and what country or
please present your passport or other form of identification, and answer the
countries (list all): ______________________________________________
questions below relevant to the presented identification document.
_____________________________________________________________
r Country issuing your passport: ____________________________
Your passport number: __________________________________
Person in your home country whom we may contact in event of an emer-
Expiration date: ________________________________________
gency (optional). Name: ________________________________________
r Driver’s license or ID card issued by a state or possession of the
Relationship: __________________________________________________
United States with a photograph. Number: _________________
Mailing address: _______________________________________________
r Identification card from the country where you are a citizen.
_____________________________________________________________
Email address: ________________________________________________
Phone: ______________________________________________________
We may ask to make a photocopy of any of the USCIS documents checked above
and, if needed, your passport and visa.
Verified by PDFFiller
Applicant’s signature ______________________________________________________________________________________________________________
4/19/22
Date ___________________________________________________________
04-19-2022 00:00
TAA Official Statewide Form 19-GG, October 2019
Copyright 2019, Texas Apartment Association, Inc.
