Found Us Via: ____________________ Initial Contact _____________________

Move-in Date: ____________________ 2nd Contact ______________________

Appointment ______________________

Client | Tenant Data Sheet

Name(s): ____________________ Phone: __________________( )
Email Address: _______________@______ . ______
Name(s): ____________________ Phone: __________________( )
Email Address: _______________@______ . _______
Move In Date(s) ___________ or _____________

Budget: $__________ - $____________

Bedroom(s): Studio Convertible 1 2 3 4

1+ Office/Den 2+ Office/Den 3+ Office/Den

Location(s): Evanston Rogers Park Edgewater Andersonville Uptown

Ravenswood Lincoln Square Albany Park North Center Roscoe Village
Wrigleyville Lakeview Lincoln Park Old Town Avondale Jefferson Park
Logan Square Bucktown Wicker Park Ukrainian Village West Town West Loop
Loop South Loop Museum Campus Hyde Park Streeterville RiverNorth Gold Coast
Sauganash Lincolnwood Edgebrook Edison Park Norwood Park Park Ridge

Transportation:

Bus: ____________________________________

EL:
Brown Red Blue Pink Purple Green Orange

Metra:
Olgilvie Union Station LaSalle Street Station Millenium Station
Van Buren Street Station

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Local Metra Stops:
UP-NW: Clyborn | Irving Park | Jefferson Park |
Gladstone | Norwood NCS: Western SWS: Wrightwood
UP-W: Kedzie | Oak Park MD-W: Western

Preferres Building Style:

High Rise Mid Rise Flat Courtyard
Condo Single Family Townhome Duplex

Amenities:
W/D Dishwasher Laundry in Building Garage Parking Assigned Parking
Street Parking Storage Deck Yard Heat Included Elevator Gym Pool

Other Amenities:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________

Floor Preference ______ Pet(s) __________ , __________ , ___________

Parking for _____ vehicles

Additional Notes: _______________________________________________

_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________

Possibilities:
Private Listing #(s) _______ , _______ , _______ , _______ , _______

MLS #(s) _________ , _________ , _________ , _________ , _________

_________ , _________ , _________ , _________ , ________ , _________

Copyright | ChiDomicile® 2011 | Phone: 773.256.8704 Fax: 773.289.0510 | info@chidomicile.net 2 of 2