Lee & Lindars

Address of Property: *
Proposed Rent:
First Name: *
Middle name(s):
Last Name: *
E-mail:
Telephone number *
Date of Birth: *	DD/MM/YY
NI Number *
Please choose *	smoker non-smoker
....	Children
....	pets
If have children, please use this box to enter name, age and gender
Current Address: *
Period at current Address: *	PLEASE ENTER IN YEARS
Current Property: *
Managing Agent/ Landlords Address:
Agent/Landlord contact number:
If time spent at current address is less than 3 yrs please use this box for previous address:
Employers Name:
Please use this box for previous address contact details:
Position held:
Employer contact:	IE - NAME OF SUPERVISOR
Contact Number:
Employers Address:
Employer e-mail:
Employment Start Date:
If employment less than 3 yrs please give previous details
Bank name:
Address:
Account name:
Account number:
Sort code
Referee Name: *
Telephone number:	(referee contact)
e-mail:
Referee Address:
Next of kin Name: *
Contact Number:
e-mail:
Address: