Your NAME: __________________________________________ Please print
Room mates NAME: __________________________________________ Please print
ADDRESS:__________________________CITY:__________________ST:____ZIP______.
YOUR present address( where you are currently living)
YOUR Landlord's NAME: ________________________________________________________
LANDLORD PHONE:______________________________FAX: ____________________
Future tenant does not fill in the following information.
Monthly Rent Amount: ________________ Lease From :__________________
Number of Tenants on lease: __________ Number of pets on lease:______
Number of Late Payments: ___________ Number of NSF Payments:_____
Lease Terms Fulfilled: YES NO Liable for next months Rent: YES NO
Proper Notice Given: YES NO Asked to Vacate: YES NO
Eviction in Process: YES NO Would you Re-rent YES NO
Any Complaints of
Damages , noise_______________________________________________________________
________________________________________________________________________________
__________________________________________________________________________________
Completed by: ______________________________________________Date_______________
Applicant hereby authorizes release of information for the purpose of processing application
information for rental verification and History.
______________________________ __________________________
Applicant’s Signature: Date: ______________________________
Applicant’s Signature: Date: __________________________
Please Return to: M & E Land Investment Corp: Fax # 423 894 9343 ASAP
THANK YOU
The Garden Apartments
M & E land Investment
PO Box 21179
Chattanooga, TN 37424-0179
423 894 6884
Fax 423 894 9343
melandinvestment@bellsouth.net