* Your name

* Daytime telephone number

* Your e-mail address

* Property address

*Your forwarding address

* Full name(s) of liable person(s) (Mr/Mrs/Miss/Ms/Other)

* Date when furniture was moved out of the property

* Date property actually unoccupied

* Total number of adult (18 years or over) occupiers moved out of the property

* Have you sold the above property?
Yes No

* If YES, give date of completion of sale

....and the name(s) of the new occupier(s) if known

* If NO, give name and address of owner/landlord

* ....and the dates of your tenancy
From To

* ....and was this rented property furnished?
Yes No