First Patriot Properties, LLC
Prospective Tenant Intake Form
Property Interested
*
113 Maple Street, Athens PA (2 Bed/1 Bath)
Self Storage, Towanda, PA
Date
*
-
Month
-
Day
Year
Date
Prospect Name
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Contact you with availability updates(check which apply) ?
Text
Email
Phone call
Do not contact me
Tenant 1 Current Employer
*
Years at this Job
*
Tenant 1 Monthly Income
*
Tenant 2 Current Employer
*
Years at this Job
*
Tenant 2 Monthly Income
*
Can Verify Income with Paystubs
*
Please Select
Yes
No
Your Credit Score
*
Please Select
Great (740 or better)
Good (670 - 740)
Poor (below 670)
Current Housing Situation
*
Please Select
Renting
Living with Family/Friends
Living in a Hotel
Homeless
Good standing with your current landlord
*
Please Select
Yes
No
N/A
Pay Rent On-Time
*
Please Select
I pay on-time every month
Sometimes I pay late
I am always late
I do not rent
Total # Occupants Living In Unit
*
Please Select
1
2
3
4
5
Year Lease Interest
*
Please Select
1 Year Lease (Good)
2 Year Lease (Great)
3 Year Lease (Spectacular)
Move In Date Required
*
-
Month
-
Day
Year
Date
Rent Assistance Required
*
Please Select
Yes - Federal or State
No
Can Provide References If Requested
*
Please Select
Yes
No
Have funds for first month rent and security deposit
*
Please Select
Yes
No
Smoker
*
Please Select
Yes
No
Pets
*
Please Select
1
2
3
4+
No
Comments
Submit
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