Date: 

To Whom It May Concern:

The person(s) named below has applied for an apartment at Elmwood Manor Apartments, and has listed you for a (current/previous) Landlord reference. We are asking for your assistance in our approval process. Please fill out the information below, at your earliest convenience, and fax (or mail) back to our leasing office. We will keep this information in confidence.

Name of Applicant(s):  

Address:  

1.  Dates of residency:  

     Amount of rent: $  

     Amount of Security Deposit: $  

2.  # of Late Payments  

     How late?  

     Were late fees paid?  

3.  Were there any lease violations?  

     If so, what was the nature of the violation?
     
 4.  Have you ever begun eviction proceedings
     for nonpayment, lease violations, or any
     other reason?  

5.  Did resident take good care of the premises?  

6.  Was proper notice given prior to vacating?  

7.  Will you (did you) keep any of the
     security deposit?  

8.  Would you rent to this applicant in the future?
     

Additional Comments:

Name of person supplying the above information:

Signature:


Thank You,
Elmwood Manor Apartments


I (we), give permission to release any and all information regarding my (our) rental history.

Signature:     Signature: