Full Name

Contact Number

Email Address

Current Address

Property Address

Property Type

Year of Construction

Last Renovation Year (if any)

Have you received any compliance notices?

• Yes

• No

If yes, please provide details

Is the property equipped with smoke detectors?

• Yes

• No

Is the electrical wiring compliant with current safety standards?

• Yes

• No

Have you conducted a radon gas test?

• Yes

• No

Have you performed an asbestos inspection?

• Yes

• No

Is there a current energy performance certificate?

• Yes

• No

Have you conducted a lead paint inspection?

• Yes

• No