Title choose.. Mr Mrs Miss Ms Dr Other
Forename(s) Surname
Address
At this address.. choose... I am the Owner I am the Main Tenant I am a lodger
If you have lived at this address for less than 3 years, please give us your previous address.
Previous Address I have lived at my current address for 3 years or more.
Telephone (daytime)
Telephone (evening)
E-mail
Date of Birth
Marital Status choose.. Married Living with partner Single Widowed Divorced Separated
Nationality
Occupation
Employer
choose.. Short Term Long Term Indefinite
Maximum Rent
I require a... choose... 3 Bedroom Property 4 Bedroom Propery Larger Property
Details of Pets
Please tell us who else will be living with you in the property.
Name 1
Name 2
Name 3
Name 4
If you are currently living in rented accommodation please give us your landlord's details. If you are not a tenant, e.g. in lodgings, please give us the details of the person to whom you pay your rent.
Name
Telephone No.
Continued on next sheet
Please provide us details of two professional referees. These should not be a relative, your present landlord or your employer.
Contact No.
If there is any other information you would like us to have when considering your application, please enter it in the box below.
Please check that you have completed all the boxes that you can, so that we have all the relevant information we need to process your application.
You can either send the completed form to us automatically by clicking the "Send the Form" button, or if you prefer, you can print the completed form by clicking the "Print the Form" button, then post it to us.
By sending this completed application form to us, you are agreeing that:
I have read and understood the above statement, and I
to these terms.
For your convenience you can answer the questions on the form above, then print it.
The printed version will include:
I declare that the information I have given on this form is true and complete, and I authorise Rangemore Estate, their employeees or agents, to undertake any necessary credit checks to process this application.
Signed ___________________________________________________________________________________________
Date ______________________________________
Please post your completed form to:
Rangemore Estate
The Estate Office
Knightley Farm
Callingwood
Needwood
Burton Upon Trent
Staffordshire
DE13 9PU
