Landlord Verification Form Name of Applicant* First Last Email* Phone*Current Resident Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Landlord Name First Last Landlord Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code PhoneFaxDates of Residency FromDates of Residency ToAmount of Monthly Rent# of Occupants# of Late Payments# of Returned Checks# of Disturbance Complaints# of Times Police Called1. Did the resident or his/her family/guest damage the apartment property?YesNo2. Did the resident pay for the damages?YesNo3. Did the resident violate the lease agreement in anyway?YesNoIf Yes checked above, please put your explanation here4. Did the resident violate any of your house/apartment rules in any way?YesNoIf Yes checked above, please put your explanation here5. Did the resident give proper notice for vacating the unit?YesNoIf Yes checked above, please put your explanation here6. Would you rent to this individual again?YesNo7. Did the resident have any pets?YesNoIf Yes checked above, what kind?Additional Comments
