Landlords / Letting Agents

Your Contact Details

Please fill out this section for you / your organisation. If you select the 'Remember me' checkbox then your computer will store this information, making it easier to complete the form each time.

Status: * Landlord Letting Agent

Title: * Mr Mrs Ms Master Miss Dr Rev

First name: *

Surname: *

Address: *

Please indicate your preferred daytime number: * Home Work Mobile

Telephone (Home):

Telephone (Work):

Telephone (Mobile):

Email: *

Remember Me: Use these contact details next time you fill out this form?

Change of tenancy:  Move In Move Out

House name/number: *

Flat name/number (if applicable):

Road/street name: *

Town/City:

County:

Postcode: *

Tenant's name(s): *

How many people live in the property?: 1 2 3 4 5 6 7 8 9

Date Tenant(s) moved in: * 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month January February March April May June July August September October November December Year 2007 2008 2009 2010 2011 2012

United Utilities account number: You can find this on your water bill

Meter serial No. (if known):

For household customers your meter will have 4 or 5 digits on a black or white background, followed by 2 or 3 in a red background. Include all the numbers on the black or white background and ignore all the red ones

Meter reading when tenant moved in (if the property has a water meter):

Responsibility for payment of water bills: * Home Property
manager Other

Tenant(s) previous address (if known):

Is this property used predominantly for commercial purposes?: * Domestic Commercial

Additional comments:

House name/number: *

Flat name/number (if applicable):

Road/street name: *

Town/City:

County:

Postcode: *

Tenant's name(s): *

Date Tenant(s) moved Out: * 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month January February March April May June July August September October November December Year 2007 2008 2009 2010 2011 2012

United Utilities account number: You can find this on your water bill

Meter serial No. (if known):

For household customers your meter will have 4 or 5 digits on a black or white background, followed by 2 or 3 in a red background. Include all the numbers on the black or white background and ignore all the red ones

Final meter reading (if the property has a water meter):

Send all bills/correspondence for vacant periods to: * This address Property
manager Other

Tenant's forwarding address (if provided):

Additional comments: