Additions / Changes:

Item 4

Rent amount: …………………………………………. Per ………………………………………

Payment received on time:  __ Always __ Sometimes   __ Never __: ……………...…...

Item 8

1) Has the Property been well maintained during the tenancy:      __ Yes   __ No

OR       

2) If the Tenant has vacated, was the Property left clean and undamaged apart from general wear and tear on vacating?      __ Yes   __ No

................................................................................................................................

Item 10

1) Do you anticipate the full rental bond to be refunded:  __ Yes   __  No

2) Was the full rental bond refunded:                             __ Yes   __  No

................................................................................................................................

Additions / Changes:

It would be greatly appreciated if you could (subject to the provisions of the Privacy Act 1988) complete the following questionnaire and return it to us by fax or email, along with the rental ledger, at your earliest convenience.

Changes:

Item 12

I authorise the Agent to forward this questionnaire to all previous Agents &/or Lessors where I have rented and request that they honestly complete the form.