LANDLORD REFERENCE Request Form

LANDLORD REFERENCE Request Form

LANDLORD REFERENCE Request Form

Applicants: Please complete PAGE 1 only.
Full Name of Applicant #1*

PrefixFirst NameMiddle NameLast Name
Full Name of Applicant #2

PrefixFirst NameMiddle NameLast Name
Applicant #1 Signature*

Clear
Applicant #2 Signature

Clear
By the signature(s) above, the above named applicant(s) have authorized Wagner Realty to check references for rental purposes. Please fill out the information requested below and submit.

- Property or Landlord Name:
- Date Moved in:   Date
  
  Moved Out:   Date
  
  Monthly Rent:   $$
  
  # of Late Payments:   #
  
  # of Returned Checks:   #
  
  # of persons on lease:   #
- Do you have any documented complaints?
  
  YESNO
- If so, Please explain:
- Was unit left in Good Condition?
  
  YESNO
- If NO, Please explain damages or cleaning needed:
- Did you or Will you return the security deposit?
  
  YESNO
- If NO, Please explain why:
- Any Rent Due?
  
  If Yes, Amount: $$
  
  Would you re-rent to this tenant?
- Additional Comments:
- Name of Person Providing Information:
  
  First NameLast Name
- Position/Title:
- Phone Number:
  Please enter a valid phone number.
- Email Address:
  example@example.com

Thank you for Completing the Rental Verification Request Form.

Please click submit below and a copy will be emailed to your Property Manager.

If you have any questions, Please reach out to:

Cynthia Grigsby

cynthia.grigsby@gmail.com

941-447-9506 (Cell)

941-756-7800 (Office)
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