Real Estate Rental Reference Request Form

Date: [Month, Day, Year]

To Whom It May Concern,

I, [Your Name], am currently in the process of renting a property and have listed [567 Property Address] as a previous residence. I hereby authorize the release of any information regarding my tenancy at the aforementioned property to [Your Company Name].

Please complete the following form and return it directly to [Your Company Email] or by mail to [Your Company Address].

Tenant Information:

Tenant Name:	[Your Name]
Previous Address:
City:
State:
Zip:
Phone Number:
Email Address:
Social Security Number (if applicable):

Rental Property Information:

Property Address:
Landlord/Property Manager Name:
Lease Start Date:	[Month, Day, Year]
Lease End Date:	[Month, Day, Year]
Monthly Rent Amount:

Rental Reference:

Please provide the following information regarding the tenant's rental history:

How long did the tenant reside at the property?
Did the tenant fulfill the terms of the lease agreement?	Yes No
Was the tenant prompt in paying rent?	Yes No
Did the tenant maintain the property well?	Yes No
Did the tenant cause any disturbances or receive complaints from neighbors?	Yes No
Would you rent to this tenant again in the future?	Yes No