RENTING ARIZONA REAL ESTATE SERVICES

5350 W. Bell Rd #C122 - 403, GLENDALE, AZ 85308

PHONE #  (602) 424-4400

FAX #       (623) 321-1035

Name:______________________________________________________________________

Current or Previous Rental Address and unit#_____________________________________

When did the original lease begin?______________________________________________

When did or will the lease expire?_______________________________________________

Has proper notice been given?_________________________________________________

Amount of rent:______________________________________________________________

Number of late payment(s):______________ Number of NSF_________________________

Would you rent to resident again?________________If no, why?_____________________

Is rent in arrears?___________________________If yes, for how much?_______________

Any lease violations? ____________If yes, for what?_______________________________

Any pets?_____________________________Any noise complaints?__________________

___________________________________________________________________________

Owner's / Manager Name + Title (Please print) _____________________________________

Owner's / Manager Name (Please sign) ___________________________________________

          I hereby authorize the release of information requested above to

          Renting Arizona Real Estate Services.

Applicant Name(s)____________________________________________________

Applicant Signature(s)_________________________________________________

To Whom it may concern:

The applicant(s) named below has applied for one of our listings. Would you could please answer the following questions and fax this form back to us. The applicant as well as our staff at Renting Arizona would appreciate it. Thank you for your time.

Applicant(s)--Please only fill out information next to a star

Rental_Verification Form