Rental Application Reference Form (3 7) - Rev 1-14
Rental Application Reference Form (3 7) - Rev 1-14
Rental Application Reference Form (3 7) - Rev 1-14
This form is used to obtain information regarding the rental history of Applicants for rental housing. The information provided by the
current or former Owner/Agent may be used solely for the purpose of evaluating the application for rental housing.
The Owner/Agent requesting this information must receive authorization from the Applicant before obtaining the information. Such
authorization is granted if Applicants signature is provided in Section 1. Copies of this form and of the Applicants signature are
acceptable. The Applicant may be contacted to verify the authenticity of this request. Please mail or fax this form to the person
listed in section 2 as soon as possible (within 24-48 hours)
TO BE COMPLETED BY APPLICANT
1. Authorization by rental Applicant for the release of information
I hereby authorize the release of the information requested on this Rental Applicant Reference Request to the Owner/Agent listed
below. I hereby acknowledge that the Owner/Agent can make copies of this executed page in order to obtain the information
requested.
Name
Phone number (
Signature
Date
2.
TO BE COMPLETED BY OWNER/AGENT
Name of Owner/Agent
Address
Unit #
City
State
Phone number (
Fax number (
Zip
Unit #
City
State
Zip
Year
or current resident
Name of Owner/Agent
Phone number (
Fax number (
Year
Phone number (