Free Survey Sheet Form Debbie Panek Active - Prestige Realty 13041 N. 35th ave suite C-1 Phoenix, Az 85029 Today's Date How did you hear about us? * How soon do you need to move? Can you view apartments today? Yes No Recently viewed any apartments? Yes No * Which Ones: Have you ever worked with another apartment locating company? Yes No Have you recently applied with any apartment? DID YOU GET DENIED? Yes No FIRST PERSON INFO Full Name(First & Last) * Home Phone Cell Phone * Email Address Current Employer Job Title Start Date Gross Monthly Income * Additional Income SECOND PERSON INFO Full Name(First & Last) Home Phone Cell Phone Email Address Current Employer Job Title Start Date Gross Monthly Income Additional Income Current Address How Long at Current Address? Are You on the Lease? * Yes No Lease Completed? Yes No If not, when does the lease end? Why do you want to move? Number Of Occupants Under 18 Years Old Number of Occupants Over 18 Years Old Ever Been Evicted or Broke a Lease or Owe a Landlord Money? * Yes No How Many? What State? How Long Ago? How Much Do You Owe? How Would You Rate Credit? * Excellent Good Fair Poor None Unsure What's Your Credit Score? Have You Ever Filed Bankruptcy? * Yes No Was It Discharged? Yes No When? Do You Have a Co-Signer if Necessary? * Yes No Do You Have Any Pets? * Yes No Pet(s) Breed Pet(s) Age Pet(s) Weight Have you ever been arrested, convicted of a Misdemeanor or Felony? * YesNo Which one FelonyMisdemeanorBoth When? What Charge? (Please be specific, the more info we have on the charge the better we can help you) What State? Are you on probation? Yes No Completed probation? Yes No When did you complete Probation ? PROPERTY LIST # of Bedrooms * Choose BedroomStudio123 # Baths AREA PREFERENCE ( Give Crossroads You Want To Live At ) North Phx South Phx East Phx West Phx What's the maximum monthly rent you can pay? $/month ( please be realistic ) * $/month How long of lease do you want? * Do you have approx. $400 for holding deposits and application fees? * Yes No What's the most you can afford for total move-in costs? Additional info we need to know Submit If you are human, leave this field blank.
