Tenant Landlord Screening Form


Please Print All Information Requestor Information

Company Name: __________________________________________________	Phone: ____________________

Contact Person: __________________________________________________	Fax: _______________________

Applicant Information

Name:______________________________________________________________________________________

Current Address:_____________________________________________________________________________

Current and Previous Landlords

Name:______________________________________________________	Phone:__________________________

Name:______________________________________________________	Phone:__________________________

Name:______________________________________________________	Phone:__________________________



In connection with my application for lease, I consent to have a background investigation made on myself as to my character, and previous rental history. 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.