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REGION (NW/MEE)

LOCAL AUTHORITY

LOCAL AUTHORITY

TYPE (Landlord / Agent)

COMPANY NAME

TRADING AS (Ltd / Sole Trader)

LANDLORD ADDRESS (Not property address)

LANDLORD EMAIL

LANDLORD TELEPHONE #

-

ARE YOU OR ANY OF YOUR FAMILY AN EMPLOYEE OF SERCO

FULL PROPERTY ADDRESS (With Postcode)

PROPERTY AVAILABLE (y/n)
YesNo

IF Tenanted - Has NTQ been served?
YesNo

Please provide a copy:

IF not yet avail – what is estimated date avail

Estimated #BEDROOMS

Estimated #BATHROOMS

PROPERTY TYPE

IF the property is a flat/apartment/Maisonette:

What floor is the property on

How many floors are in the building

I confirm that the information given are true at time of completion of this form.

Signed:

Dated :

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