P.O. Box 3940
     2948 Reed Street Suite 100
     Philadelphia, PA 19146
     (215) 463-3477     Office
     (215) 463-3475     Fax
     CC-FS@CC-FS.com    Email

This Form Must Be Completed To Schedule The Appointment!
No appointment will be given unless this form is fully completed.

1) First/Last/Maiden Name
/ /

A.) If any other adults how many?  
     Who?

B.) If children how many? Ages?

2) Current Address?

Previous?(If at current address for less than 5 years)

A.) Phone Number? (H) (W) (C)

B.) How long have you lived there? (Years) (Months)

C.) Why are you moving?

3) Work Status? (Current Employer)

A.) How long have you been employed?

B.) How much is your monthly taking home pay?

4) How’s your credit? Good / Fair / Poor (Please Explain!)

A.) Do you currently pay your rent/bills? (Y/N) On time? (Y/N)

5) Can you complete a rental application prior to seeing the property? (Y/N)

A) Will the $ 35.00 application fee (per adult) be a problem for you? (Y/N)

B.) Can you afford $ 650.00, per month plus Gas, Electric and Water? (Y/N)

C.) Can you pay $ 1,950.00 ? to move in? (Y/N)
Do you currently have it? (Y/N)

6) Do you have a checking account? (Y/N)

Do you have a savings account? (Y/N)
A.) Current Balance? $
B.) Average Balance? $
C) Any NSF? (Y/N)

7.) What day would you like to see the property?
What Time?