| Tenant Credit Release Form |
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Print Form, Complete
and Fax to: 509-692-7298 |
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Please Print All Information |
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| Company Name:________________________________________________ |
Phone: ______________________________ |
Contact Person:_______________________________________________ |
Fax: ________________________________ |
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Applicant Information |
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Name: _______________________________________________ |
Phone:_______________________________ |
| Social Security Number:________________________________ | Date Of Birth:_______________________________ |
Drivers License Number:______________________________________________ |
State Of Issue:______________________________ |
Current Address:_________________________________________ |
City and State: ____________________ |
Zip: ________ |
How Long _____________ |
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Previous |
City and
State:
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Zip:
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How Long |
In
connection with my application for lease, I consent to have a background
investigation made as to my character, employment history, credit history, criminal
record, driving record, workers compensation claims, professional licenses,
educational background and/or other reports.
These reports can include information as to
my character, work habits, performance, education and experience along with
reasons for termination of employment from previous employers, if any. I
understand that you may be requesting information from various Federal, State, and other agencies
who maintain records
concerning past activities relating to my credit, criminal, driving, civil and
other records and experiences, including any claims involving me in the files of
insurance companies.
By this Authorization for Release of information and for the Procurement of a
Consumer or Investigative Consumer Report, I hereby forever release, discharge,
exonerate, hold harmless and indemnify Affiliated Background Searches, Inc., its
employees, representatives, agents and subcontractors and any other person, entity,
organization or institution furnishing information to them from any and all
liabilities of every nature and kind, including but not limited to claims for
libel, slander, invasion of privacy, related tort claims, misuse of information
obtained from Affiliated Background Searches, Inc., and any other claim or cause
of action arising out of providing this information. I understand
that a photocopy or facsimile of this signed document shall be considered as
valid and original.
| Applicant's Signature: X_________________________________________________________Date:_________________________________ |