RC: 1306992

YAMUSAD CONCEPT INTERNATIONAL LTD

REAL ESTATE AND GENERAL MERCHANDISE

Address: 2nd Avenue 212 Road, House 8

Efab Global Estate, Abuja.
PASSPORT Address: 5th Avenue, G Close, House 9
Festac Town, Lagos
Tel: 08067127259, 09017057556
email address: adamubayawoab@gmail.com

TENANCY REQUEST FORM

A. BIO-DATA:
Name (Surname first)……………………………………………………………………………………………………
Sex……………………………… State of Origin………………………….. Religion……………………………….
Local Govt. Area………………………………………………… Town or Village…………………………………
Occupation………………………………………………. Telephone Nos:…………………………………………
Marital Status……………………………………… No. of Dependants (if any)………………………………
Contact Address………………………………………………………………………………………………………………
………………………………………………E-mail……………………………………………………………………………..
B. EMPLOYMENT DETAILS:
Name of Employer………………………………………………………………………………………………………….
Address of Employer………………………………………………………………………………………………………
Nature of Business…………………………………………………………. Telephone Nos………………………
C. ACCOMMODATION:
Type required…………………………………………………… Flat/BQ………………………………………
State Reason (s) for leaving current place of residence……………………………………………………..
……………………………………………………………………………………………………………………………………….
D. AFFIRMATION:
I/We……………………………………………………………………………… hereby affirm that the
information given above are true and correct to the best of my knowledge, and pledge to
abide by the rules and regulations guiding my Tenancy, if granted. Also, I/We agree to sign
and execute a Tenancy Agreement on the subject property.

SIGNATURE:………………………………….. DATE:………………………………….
 E. UNDERTAKING FROM A GUARANTOR:
I………………………………………………………….(Name in full) a Nigerian of………………….State
of Origin and presently residing at No………………………………………………………………………………..
………………………………………………………………………………………………….do hereby certify that
Mr/ Mrs / Miss………………………………………………………………………….(Names in full) is well
known to me, and is very responsible and not of a questionable character. I certify that
He/She is able to pay the annual rent of N…………………………………………….NET of Taxes or
other statutory Deductions) in advance or any other subsequent upward review as
mutually agreed with the Landlord/Landlady.

In the event of default on his/her obligations I hereby undertake to assume full

responsibility on his/her behalf and fully discharge all outstanding obligations.
Signature…………………………………………………………Date………………………………………………
Office Address…………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………….
Occupation………………………………………………………………………………………………………………
Telephone Nos……………………………………………………………………………………………………….
Note: Please attach photocopy of of ID Card/ National ID Card/Driver’s License or
International passport.

F. Agreed Rent……………………………………………………………………………………………….(Yearly)
Mode of payment cash/Other (Specify)…………………………………………………………………..

PROCESSING AGENT………………………………………………………………………………
ADDRESS OF AGENT……………………………………………………………………………….
Signature/Stamp……………………………………………………
Date……………………………………………………………………….