Landlord Reference Request Form - Priority Property Management LLC

Sep 15, 2026

Uploaded by Ophelia

Landlord Reference Request Form collects a tenant’s authorization for a free and complete release of tenancy information under Virginia Code 55-248.9:1. The form requests a landlord or property manager to confirm key rental details, including move-in dates, rent amount and utility inclusion, late-payment history, damages or lease violations, security deposit refund status, and neighbor complaints. It also asks whether the tenant completed the lease term, received official notice, vacated due to landlord or court order, is current on payments, has pets, and would be leased again.

LanguageEnglish

CategoryForms

FormatPDF

Pages1

AccessFree to download

Landlord Reference Request Form

Tenant Authorization

Landlord Information Request Items

Sign-off and Contact Details

(Office)540.578.4974 (fax) 540.908.3633 [contact@ChoosePriority.com](contact@ChoosePriority.com)[ ](contact@ChoosePriority.com)[www.ChoosePriority.com](www.ChoosePriority.com) LANDLORD REFERENCE REQUEST FORM | TENANT’S AUTHORIZATION PURSUANT TO VIRGINIA CODE 55-248.9:1
I authorize the free and complete release of all information about my tenancy at ANY rental unit, and agree to hold harmless anyone who so responds in good faith. A copy/fax of this authorization shall be accepted as if original. | | | | --- | --- | --- | | Name of Applicant | Signature of Applicant | Date | | Name of Applicant | Signature of Applicant | Date | Hello Management/Landlord; The Tenant(s) named above have applied with PPM for a rental unit and have authorized disclosure of information. We understand you have previously rented or are currently) renting to them at: Please furnish the following information as applicable and return by fax, email, mail or in person. We cannot consider this form valid if delivered by the tenants themselves. 1. When did the Tenant rent from you? From To 2. Rent amount during last month of tenancy? Were any utilities included? 3. Rent was received more than 5 days late times (Please indicate 0 or number of times) 4. Any property damages or lease violations at any time during tenancy? Yes No If yes, for what reason(s)? 5. Did/will the Tenant receive the full security deposit refund? Yes No N/A (Pending Move-Out) 6. Have you ever received any complaints from neighbors of Tenant? Yes No If yes, what kind? 7. Has Tenant completed the lease term? Yes No Given official notice? Yes No 8. Was Tenant asked to vacate by Landlord, Agent, or Court Order? Yes No If yes, for what reasons(s)? 9. Is Tenant current with all lease payments and any outstanding fees? Yes No 10. Are you related to Tenant by family or marriage? Yes No 11. Did/Does Tenant(s) have any pets? Yes No How many & what kind/size? 12. Would you lease to Tenant again? Yes No 13. Add any more comments or concerns: Signed by Authorized Manager, Landlord, or Agent Responding Print Name Date Priority Property Management LLC • 737 E. Market Street, Harrisonburg, VA 22801 • Licensed in Virginia

FAQs

What information must the landlord provide on this form?

The landlord is asked to confirm rental dates, rent amount and whether utilities were included, late rent history, any damages or lease violations, security deposit refund status, neighbor complaints, lease completion and notice, and whether the tenant was asked to vacate by landlord, agent, or court order.

Why can’t the form be delivered by the tenants themselves?

The form states it cannot be considered valid if delivered by the tenants; it must be returned by fax, email, mail, or in person.

Is security deposit information included in the request?

Yes. The form asks whether the tenant received the full security deposit refund, or whether it is pending move-out (N/A).

Sep 15, 2026

Uploaded by Ophelia