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First Name

Email

Last Name

Phone

What is your rental budget, not including utilities (gas, water, electric, and internet/TV)?

What is your preferred move in date

What property or properties are you inquiring about?

How many bedrooms are you looking for? (select all that apply)

1 Bed

2 Bed

3 Bed

Other

If other is selected

Date of Birth

Present Address

How long have you lived there?

How much rent did you pay?

What is your reason for moving?

Who is the Owner/Manager of your residence?

What is the Owner/Manager's phone number?

2nd Previous Address

2nd Address - How long did you live there?

2nd Address - How much rent did you pay?

2nd Address - What was your reason for moving?

2nd Address - Who was the Owner/Manager of your residence?

2nd Address - What was the Owner/Manager's phone number?

What is the name and relationship of every person that is going to occupy the dwelling?

Do you have any pets? Please check all that apply

None

Cat

Dog

Reptile

Gerbil or small rodent

Other

If Other is selected

Present Occupation

Employer

Office Phone

How long have you been with this employer?

Supervisor Name

Supervisor Phone

Add answer here

Previous Occupation

Previous Employer

Phone of Previous Employer

How long were you with this employer?

Supervisor of Previous Employer

Phone of Previous Supervisor

Current gross income per year (household) *

$10-$25k

$25-$35k

$35-$45k

$50-$75k

$75k+

Other

If other is selected

Non-personal Reference #1 Name, Phone, and Relationship to you

Non-personal Reference #2 Name, Phone, and Relationship to you

Non-personal Reference #3 Name, Phone, and Relationship to you

Have you ever filed bankruptcy? *

Yes

No

Other

If other is selected

Have you ever been evicted *

Yes

No

Other

Have you ever been convicted of a crime? *

Yes

No

Do you consent that all of the information you have said is correct and valid? *

Yes

No

I agree to receive marketing and customer service calls and text messages from Pezzimenti Realty. Consent is not a condition of purchase. Msg/data rates may apply. Msg frequency varies. Reply STOP to unsubscribe. Data will not be shared with third parties for marketing or promotional purposes.Privacy Policy & Terms of Service

Disclaimer: By entering your information and submitting this form, you agree to our Terms of Use and Privacy Policy and that you may be contacted by Paul Pezzimenti Real Estate | Howard Hanna Professionals by phone, text message and email about your real estate interests. Frequency of contact may vary and message and data rates may apply. For assistance call 716-378-7039 or text STOP to cancel.

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Home
Become a Client
About
Commercial
- Listings
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Resources
Sample Listings
Reviews

Email: paul@paulpezzimenti.com

Phone: 716-378-7039

Office: 716-372-1155
License Number: 10301214758
410 Wayne Street
Olean, NY 14760

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