Rental Reference Request
Applicants Name/s
Property Rented
Street Address
Street Address Line 2
City
State
Postal / Zip Code
Was the tenant/s listed as a Lessee?
Yes
No
Rent per week
Period of occupancy
Did the tenant receive any Form 11's?
Yes
No
If Yes, why? (select multiple where applicable)
Rent Arrears
Damage
Noise
Unapproved occupants
Unapproved pets
Other
Were periodic inspections conducted during the tenancy?
Yes
No
Was any damage noted during the inspection?
Yes
No
If Yes, what damage?
Did your office terminate the tenancy?
Yes
No
If Yes, why?
Were pets kept on the premises without permission?
Yes
No
Did the Tenant leave the property clean and tidy
Yes
No
Still in residence
Was the bond refunded in full
Yes
No
If No, what deductions were made (select multiple where applicable)
Arrears
Damages
Water
Monies owing over and above bond
Other
Would your Agency rent to this person again?
Yes
No
Additional Comments:
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