Occupier(s) Full Name(s)

Date of Birth(s)

Current Address(s)

Telephone number(s) (home)

Telephone number(s) (mobile)

Telephone number(s) (work)

Email Address(s)

Do you have any children under the age of 18 that will be living at the property?

Please provide details of your Job roles:

Employment Type

Does your income/combined income meet the affordability of the property? (Rent X 2.5 X 12)

How much does each person earn per year?

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At Lang Town and Country we maintain the highest professional standards by conforming to guidelines set by the industry’s leading bodies, including the Association of Residential Letting Agents and the National Association of Estate Agents.

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