Landlord Rental Profile

Rental Questionnaire

Listing your rental with me is simple. All you need to do is fill out the rental listing form below. I will contact you to review the information and discuss details about your property. There is no charge to list your rental until we find a tenant.

Please fill out each field in the form below. You must fill out this form for each property that you wish to offer for rental. Some fields may not be applicable. Fields marked with an asterisk (*) are required. Upon completion of the form press the SUBMIT button at the bottom of the form. The data will be submitted to me via e-mail. I will contact you if I require additional information or paperwork. If you would prefer to submit this information in person or have any questions, please call me at (772 ) 288-1765.

Rental Property Owner(s) Information

Owner's Full Name*

Co-Owner's Full Name

Owner's Home Address*

Owner's Home City* State* Zip*

Owner's Daytime Phone* Alternate Phone*

Owner's FAX E-mail*

I / We (the above owners) have read and
DO agree DO NOT agree to all of the following terms:

I / We agree to provide key and/or security access code upon completion of an Exclusive Right to Lease agreement.

For ANNUAL, WINTER OR SEASONAL rentals, Century21 Horizon Properties will collect the initial rental payment and security deposit(s) ONLY. All other rental payments will be made directly to you by the tenant. You are responsible for holding and refunding the SECURITY DEPOSIT.

I / We understand the commission rate charged by Century21 Horizon Properties is TEN (10%) PERCENT of the total rent for annual rentals or FIFTEEN (15%) PERCENT of the total rent for seasonal, Winter or short term rentals, which will be deducted from the initial payment collected when the lease is signed by the tenant. I / We hereby authorize Century21 Horizon Properties to advertise the property for rent at the rate(s) and terms described herein upon completion of an Exclusive Right to Lease agreement..

Rental Property Description.

Property Street Address*:

City, State, Zip*

Rates

Period	In Season	Off Season
Monthly	US$	US$
Season	US$	US$
Annual / per month	US$
Comments	Insert comments about your rental here:

Security Deposit:

US$

Pet Deposit:

US$

Dates Available:

Dates Booked:

Parking:

Maximum Occupancy:

Number of Bedrooms:

Number of Beds:

King Queen
Full Single

Number of Baths:

Pets:

No Yes

Smoking:

No Yes

Central Air Conditioning:

No Yes

Water Views:

No Yes

Deck:

No Yes

Yard:

No Yes

Patio:

No Yes

Living Room:

No Yes

Dining Room:

No Yes

Kitchen:

No Yes

Den:

No Yes

Fireplace(s):

No Yes

Central Heat:

No Yes

Ceiling Fan(s):

No Yes

Cable TV:

No Yes

Furnished:

No Yes

Telephone:

No Yes

Washer/Dryer:

No Yes

Dishwasher:

No Yes

Refrigerator:

No Yes

Stove/Oven:

No Yes

Lawn Service

No Yes

Garbage Removal

No Yes

Home Owners Association

No Yes

Please review the above information to check for errors.

I have reviewed the Century21 Horizon Properties Terms and Conditions for listing a rental. I agree by filling out this questionnaire, Century21 Horizon Properties is not responsible for the tenant I choose. I agree to hold Century21 Horizon Properties harmless from any liability in connection with this questionnaire and my relationship with the tenant(s) I choose.