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 ___________________________________