Tenant Information Record



Your name

Your address

Soc. Sec. No.

Your home phone

Work Phone

Who lives with you? (include ages of children please)

What pet(s) do you have?

Do you have a waterbed?

What vehicle(s) do you have? Make(s)

License(s)

Where do you work? (Company Name)

Where does your co-tenant work?

When did you move in?

What is your current rent per month?

What date is your rent paid up to right now?

When is your rent due each month?

What refundable deposits have you paid?

Keys$

Security $

Cleaning $

Other (please explain) $

When you moved in, you paid your first month's rent. Did you also then pay your last month's rent? If so, how much was it? $

Which of the following furnishings in your dwelling belong to the owners of the building? (Please give room locations where appropriate)

Carpets

Drapes

Shades

Blinds

Stove

Refrigerator

Other

appliances (Please list)

Other Furniture (Please list)

Do you have a rental agreement or lease in writing?

If so, what is the date of the latest one

In case of an emergency, what friend or relative should we contact?

Name Phone No.

Date _______________ Your Signature _____________________