Rent Amount:                                                         Proper Notice Given:                            

Evictions:                                                               Balance Owing:                                    

Completed Lease Term:                                        Lease End Date:                                    

Did tenant have pets:                         How many:                  Type/Breed:                          

Has Tenant(s) paid late:                        # of times:                    # of NSF:                           
Any documented complaints (disturbances, etc.,)                                                               
                                                                                                                                            
Comments:                                                                                                                          

Would You Re-Rent:                                                                                                             

Verified by:                                                                                          Date_______________