This form contains 9 fields organized into 4 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Confirmation Details
Tenant Name Text
Please enter the full name of the tenant.
Max length: 90 characters
Tenant Acknowledgment Name Text
Please enter the tenant's full name to acknowledge receipt of keys and access to the property.
Max length: 112 characters
Occupancy Date (Month & Day) Date
Please enter the month and day for the occupancy date.
Max length: 32 characters
MLS Number Text
Please enter the Multiple Listing Service (MLS) number for the property.
Max length: 36 characters
Occupancy Year (YY) Text
Please enter the last two digits of the occupancy year.
Max length: 5 characters
Landlord Name
Landlord Name Text
Please provide the full name of the landlord.
Max length: 90 characters
Property Address Line 1
Property Address Text
Enter the full property address for the rental property.
Max length: 90 characters
Tenant Signature
Tenant Signature Text
The tenant’s handwritten signature acknowledging receipt of the keys and full access to the rental property as of the occupancy date.
Max length: 57 characters
Signature Date Date
Please enter the date the tenant signed the document.
Max length: 38 characters