UNPAID RENTS PROTECTION QUESTIONS Please fill in and send along with an application to Unit #1 Unit #2 Unit #3 Unit #4 Unit #5 Unit #6 ABOUT EACH RENTAL UNIT Address Monthly rent Unpaid rent or more than 2 weeks late Yes No Yes No Yes No Yes No Yes No Yes No during past 12 months? ABOUT TENANTS Signed lease Yes No Yes No Yes No Yes No Yes No Yes No credit score at 660 or Yes No Yes No Yes No Yes No Yes No Yes No above Don’t know Don’t know Don’t know Don’t know Don’t know Don’t know Rent < 40% of Yes No Yes No Yes No Yes No Yes No Yes No tenant’s gross income Don’t know Don’t know Don’t know Don’t know Don’t know Don’t know 1-month deposit Yes No Yes No Yes No Yes No Yes No Yes No their own Renter Yes No Yes No Yes No Yes No Yes No Yes No insurance Don’t know Don’t know Don’t know Don’t know Don’t know Don’t know Employed Employed Employed Employed Employed Employed Students Students Students Students Students Students Retirees Retirees Retirees Retirees Retirees Retirees Occupation Unemployed / Unemployed / Unemployed / Unemployed / Unemployed / Unemployed / Social Assistance / Social Assistance / Social Assistance / Social Assistance / Social Assistance / Social Assistance / Disability Disability Disability Disability Disability Disability Unrelated people Yes No Yes No Yes No Yes No Yes No Yes No living together Comments: ____________________________________ Print name of proposed insured Signature of Applicant & Title Date ___________________________ Signature of Broker Date
UNPAID RENTS PROTECTION QUESTIONS Please fill in and send along with an application to Unit #1 Unit #2 Unit #3 Unit #4 Unit #5 Unit #6 ABOUT EACH RENTAL UNIT Address Monthly rent Unpaid rent or more than 2 weeks late during past 12 months? Yes No Yes No Yes No Yes No Yes No Yes No ABOUT TENANTS Signed lease Yes No Yes No Yes No Yes No Yes No Yes No credit score at 660 or above Yes No Don’t know Yes No Don’t know Yes No Don’t know Yes No Don’t know Yes No Don’t know Yes No Don’t know Rent < 40% of tenant’s gross income Yes No Don’t know Yes No Don’t know Yes No Don’t know Yes No Don’t know Yes No Don’t know Yes No Don’t know 1-month deposit Yes No Yes No Yes No Yes No Yes No Yes No their own Renter insurance Yes No Don’t know Yes No Don’t know Yes No Don’t know Yes No Don’t know Yes No Don’t know Yes No Don’t know Occupation Employed Students Retirees Unemployed / Social Assistance / Disability Employed Students Retirees Unemployed / Social Assistance / Disability Employed Students Retirees Unemployed / Social Assistance / Disability Employed Students Retirees Unemployed / Social Assistance / Disability Employed Students Retirees Unemployed / Social Assistance / Disability Employed Students Retirees Unemployed / Social Assistance / Disability Unrelated people living together Yes No Yes No Yes No Yes No Yes No Yes No Comments: ____________________________________ Print name of proposed insured Signature of Applicant & Title Date ___________________________ Signature of Broker Date
Unpaid-Rents-Protection-Supplemental-questionnaire.docx