Tenant Assessment Application Form Page 2
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1
2
3
4
5Do you intend to
Are you a
Yes
No
Yes
No
keep pets at the
smoker?
property?
If yes, please
state which type
of pet & breed
Are you aware of any County Court Judgements/CD Bankruptcy orders, spent, current or pending?
Yes
No
(please tick) If yes give details
Names of children living in the property and their dates of birth:
1.
/
/
2.
/
/
3.
/
/
4.
/
/
Current address:
House Number / Name
Flat number / Name
Street
Town
County
Postcode
Status (tick one)
Owner
Rented
Living with parents
Council tenant
Other (please specify)
How long at this address?
Years
Months
If the above property is rented
£
per month
how much rent do you pay?
Previous address:
House Number / Name
Flat number / Name
Street
Town
County
Postcode
Status (tick one)
Owner
Rented
Living with parents
Council tenant
Other (please specify)
How long at this address?
Years
Months
If the above property is rented
£
per month
how much rent do you pay?
The information contained within this application is being transmitted to and is intended only for the use of Let Insurance Services. If the reader is not the intended
recipient, you are hereby advised any dissemination, distribution or copy of this application is strictly prohibited. If you have received this application in error, please
immediately notify us by calling 0844 478 1600
LIS Tenant Assessment Application Fax Form – April 2011
Page 2 of 5
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