Tenant Self-Disclosure Form
Mieterselbstauskunft — Please fill in all fields as completely as possible
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The form is in
English
for easy filling — the generated PDF will be in
German
for your landlord.
1
Personal Information
Salutation
Please select
Ms.
Mr.
Non-binary / Other
Full Name (First and Last)
Date of Birth
Place of Birth
Nationality
ID Card / Passport No. (optional)
Phone Number
Email Address
2
Current Address
Street & House Number
Postal Code
City
Resident Since
Type of Accommodation
Please select
Rented apartment
Owner-occupied apartment / house
Sublet
With family / friends
Student dormitory
Other
Current Landlord (if applicable)
Landlord's Name
Landlord's Phone
3
Planned Move-in & Occupants
Desired Move-in Date
Total Number of Occupants
Name(s) of Other Adults
Children (number and ages)
Pets?
No
Yes
Type and number of pets
Vehicles (car / motorbike)?
No
Yes
Type and number of vehicles
4
Employment & Income
Employment Status
Please select
Employed — permanent contract
Employed — fixed-term contract
Self-employed / Freelance
Civil servant (Beamte/r)
Retired / Pensioner
Student / Apprentice
Unemployed / Job-seeking
Other
Employer / Company Name
Industry / Field
Employed Since
Fixed-term Until (if applicable)
Employer's Address (optional)
Monthly Net Income (€)
Additional Monthly Income (€)
Source of Additional Income
5
Financial Situation
Current Monthly Rent (€)
Insolvency proceedings or statutory declaration currently ongoing?
No
Yes
Please explain (optional)
Rent arrears or eviction proceedings in the past?
No
Yes
Please explain
SCHUFA credit report available?
Yes, can be provided
No
Being requested
6
Additional Notes
Special Notes / Remarks
City (where signed)
Date
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