Landlord Reference Form Home Rental Properties - Bob and Tena Wenta 1297 Highland Hall Road -Boone, NC 28607 Phone: 828-262-1282

Applicant’s Name(s):______, ______. Phone Number(s): ______, ______. Address of Property wanting to rent, ______Russellville, KY 42276.

Landlord: Please Fill Out and Complete: Name of Landlord giving this referral: ______. Phone:______. E-mail: ______. (✔) Check One: ______Current Landlord ______Previous Landlord ______Family Member  Date of Applicants Tenancy from: ______To: ______. Address of Property Rented: ______, City:______, State:_____. 1. Rent Payment: (If answered “Yes”, please describe below on line 4.) A. Is (Was) applicant current on rent? ____YES ____NO B. Has (Had) applicant ever been late? ____YES ____NO C. If “YES”, How long late? ______. How Often: ______. D. Have you ever filed for an eviction for this applicant? ____YES ____NO 2. Housekeeping: (If answered “Yes”, please describe below on line 4.) A. Does (Did) the applicant keep the property clean inside? ____YES ____NO B. Is (Was) the yard kept clean of personal belongs, and maintained? ____YES ____NO C. Has (Had) the applicant damaged the property? ____YES ____NO D. Has (Had) the applicant paid for damage(s)? ____YES ____NO E. Will you (did you) keep any Security/Damage Deposit? ____YES ____NO F. Has (Had) utilities ever been disconnected for nonpayment? ____YES ____NO 3. General: (If answered “Yes”, please describe below on line 4.) A. Does (Did) applicant have other than those on lease live with them? ____YES ____NO B. Does (Did) the applicant have any pets? ____YES ____NO C. Is (Was) pet well behaved? Any pet damages to yard or house? ____YES ____NO D. Will (Was) applicant’s Pet Deposit returned? ____YES ____NO E. Has (Had) the applicant or guest of applicant damage yard or left trash? ____YES ____NO F. Does (Did) the applicant interfere with the noise ordinance? ____YES ____NO G. Was (Were) there any complaints from neighbors or police? ____YES ____NO H. Has (Had) the applicant ever given false information? ____YES ____NO I. Has (Had) the applicant(s), family member, or guest engaged in criminal activity or drug related activity on your property? ____YES ____NO J. Has (Had) applicant(s) been convicted of a felony, arrested, or jailed? ____YES ____NO K. Would you rent to this applicant again? ____YES ____NO If ”No”, describe:______. 4. Other remarks regarding applicant: ______

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 Landlord’s Signature:______. Date:______.

Please send The Landlord Reference Form by Fax: 828-265-4490 or by E-mail: [email protected]

Thanks for your cooperation! Tena Wenta Owner/Manager