RE 71-20

Rev. 2/2007

(This or letterhead)

STATE OF OHIO

OHIO DEPARTMENT OF TRANSPORTATION

Re:	Applicant’s Reference Request

Dear	Landlord Name

I have included a tenant reference request form for the rental applicant listed on the attached form. Please fill in the form to the extent that you can and return it to me. I have also enclosed a release signed by the tenant allowing you to disclose the relevant information.

I you have any questions please contact me at the phone number listed below.

Respectfully,

Name
Title
Address
Phone Number
E-Mail Address
Enclosure:
cc:	File

TENANT REFERENCE REQUEST

Applicant’s Name:
Current Address:
Name of person contacted:	Phone:
Current Landlord Previous Landlord Other
Dates of Applicant’s Tenancy:	From	To
1. Rent Payment:	Yes	No
A. Rental Rate:
B. Is or was Applicant current on rent?
C. Has or had he/she ever been late?
How late?	How often?
2. Caring for the unit:
A. Does or did the applicant keep the unit clean?
B. Has or had the applicant damaged the unit?
Describe damage:
How expensive?	How often?
C. Has or had the applicant paid for the damage?
D. Will you or did you keep any of the security deposit?
3. General:
A. Does or did the applicant permit persons other then those on the lease to live in the unit?
B. Has or had the applicant or family members damaged or vandalized the common areas if any?
C. Does or did the applicant create any physical hazards to the project or residents? If yes describe.
D. Does or did the applicant interfere with the rights and quite enjoyment of other residents? If yes
describe
E. Has or had the applicant given you any false information?
F. Would you re-admit this applicant?
G. Is this tenant in the process of being evicted?
Date:
(Signature of landlord or authorized representative
Print name and title

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RE 71-19

Sandy Feyh

2007-03-22

deaton

Ohio Department of Transportation