Please submit the name or names and address of tenants that lived in your home, moved and owes you money. Tenants you have taken to court and evicted. Also submit your name and contact information. Please answer the questionaire.

Do Not Abbreviate
Tenant
*First Name	*Last Name
*Street Address
*City
*State Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip Code
*Country
Phone #

Landlord
*First Name	*Last Name
*Email

About Tenant
Was your tenant a good paying tenant?	Yes No
Was your tenant very noisy?	Yes No
Did your tenant pay on time?	Yes No
Was your tenant verbally abusive?	Yes No
Did your tenant stop paying rent?	Yes No
Did you serve tenant with a notice to vacate?	Yes No
Did you go to Court?	Yes No
How long did the tenant stay in your home after notice to vacate?	Less than six months Six months or more More than one year
Did the tenant leave owing you money?	Yes No
If this is a rental property only, did you received complaint about your tenant?	Yes No
Did you ever feel threatened by your tenant?	Yes No
Did your tenant damage your property during the process?	Yes No
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