Tenant Estoppel Certificate Page 2

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Names of all adults in possession:
First Name:
Last Name:
Date of Move-In (approximate):
Mo.
Date
Year
Mo.
Date
Year
Mo.
Date
Year
Names of all minors (under 18) in possession:
First Name:
Last Name:
Date of Move-In (approximate):
Mo.
Date
Year
Mo.
Date
Year
Mo.
Date
Year
Current Monthly Rent: $
.
Date this rent became effective: Mo.
Date
Year
Previous Monthly Rent: $
.
Tenant is in possession of the premises, and has not assigned or sublet any portion of the
premises.
If the agreement is a lease, the current term is for
years, ending Mo.
Date
Year
Lease renewal/extension option term(s) run(s) until Mo.
Date
Year
No incentives, bonuses, free rent, discounts or refunds on the rental amount were given
Tenant, except:
.

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