Property Address

Apt. #

Bedrooms BedroomsStudio1 Bedroom2 Bedroom3 Bedroom4 Bedroom

Monthly Rent

Lease Holder Name

Tenant Phone Number

Email Address

Name of Occupant 1

Name of Occupant 2

Name of Occupant 3

Number of Occupants Number of Occupants12345678

Name of Occupant 4

Name of Occupant 5

Name of Occupant 7

Name of Occupant 8

Name of Occupant 6

When Does Your Lease Expire?

Do you have a copy of your lease? Do you have a copy of your lease? Yes No

How Long Have You Lived Here? (Years & Months)

What utilities do you pay? What utilities do you pay? Gas Electric Water None

How many pets do you have? How many pets do you have?012345

Pet 1: Type and Breed (Example: Dog, Golden Retriever)

Pet 2: Type and Breed (Example: Dog, Golden Retriever)

Pet 3: Type and Breed (Example: Dog, Golden Retriever)

Pet 4: Type and Breed (Example: Dog, Golden Retriever)

Pet 5: Type and Breed (Example: Dog, Golden Retriever)

Emergency Contact Person

Do you receive any rent subsidy? (Example: Section 8) Do you receive any rent subsidy? (Example: Section 8) Yes No

Relationship to Emergency Contact

Do you have any current maintenance issues? Do you have any current maintenance issues? Yes No

Please list and describe your maintenance issues

Emergency Contact Phone Number

List any additional questions or comments here