Tenant Questionnaire

Name:

Social Security #:

Name:

Social Security #:

Current Telephone Numbers
Day:

Evening:

Other:

Address of Damaged Property:



How long have you lived at the damaged property?

Year(s)

Month(s)
If you no longer live at the damaged property, what date did you move?

How many bedrooms does (did) your damaged rental property have? 

How many people live(d) there?


How much is (was) your monthly rent?


Property Owner’s Name:

Telephone:

Property Owner’s Address:





Thank you for taking the time to complete this questionnaire.
Form II-6, Tenant Questionnaire
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