TENANT INFORMATION

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 ___________________________________