INTERNATIONAL HARVESTER
APARTMENT HOMES
@ BANBURY PLACE
715-836-6828
 www.banbury.com

PREVIOUS LANDLORD REFERENCE

POTENTIAL APPLICANTS.  IF POSSIBLE, ASK YOUR PREVIOUS LANDLORD TO VISIT THIS PAGE AND ENTER THE INFORMATION ABOUT YOU.
 

I hereby request and authorize the following information to be released to BANBURY PLACE, INC. 

Applicant's Name  Date 

Applicant's Name  Date 

        

FOR LANDLORD USE ONLY 

Owner/ Manager: The above identified person recently applied for housing and indicated tenancy in your property at: 

Please complete the information below. 

  1. When did the applicant reside at this address?

  2. How many bedrooms? Number of occupants:

  3. What was the monthly rent? Subsidized

  4. Was the applicant ever late with rent payments?

  5. Were utilities included in rent? If no, average cost?

  6. Did the applicant permit persons other than those on the lease to live in the apartment on a regular basis?

  7. Did applicant maintain desirable living conditions (clean, safe & sanitary)? If no, please explain:

  8. Has the applicant, family members or guests damaged or vandalized the apartment or common areas?

  9. Has the applicant, family members or guests engaged in any criminal activity, including drug related criminal activity in the apartment or surrounding areas?

  10. Was applicant compatible with other residents?

  11. How was applicant's overall conduct while residing in the apartment? 

  12. How was applicant's supervision and conduct of his/her children while in the apartment/common areas? 

  13. Was the unit in acceptable condition when you last observed?

  14. Would you rent to the applicant in the future? If not, please explain:

  15. Are you a friend or relative of the applicant? If so, please describe relationship:

NAME                DATE

  TITLE               PHONE

 THANK YOU FOP COMPLETING THIS QUESTIONNAIRE. EITHER PRINT OUT THIS QUESTIONNAIRE AND MAIL IT IN OR SUBMIT IT.  THANK YOU.