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TENANT SCREENING AUTHORIZATION

Authorization For Release of Information For Tenant Screening

 Complete and Fax to:  509-692-7298
Questions?  Call:  800-420-4233 


Please Print All Information
Requestor Information 


Company Name:__________________________________________________ 

Phone:_____________________ 


Contact Person:___________________________________________________ 

Fax:_______________________ 


Applicant Information


Name:______________________________________________________________________________________

Current Address:_____________________________________________________________________________


City: __________________________ State: ________________________ Zip Code: _______________


SSN: __________________________ DOB: _________________________ Gender: _____________

Drivers License Number:_______________________________________________________ State Of Issuance:________

Current and Previous Landlords


Name:______________________________________________________ Phone:__________________________

Name:______________________________________________________ Phone:__________________________

Name:______________________________________________________ Phone:__________________________

Current Employer



Company Name: ___________________________________________________________________________

Supervisor: ____________________________________________________Phone: (_____) ______________

Position: _______________________________________________________Salary: ____________________

n connection with my application for lease, I consent to have a background investigation made on myself as to my character, employment history, credit history, criminal record, 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.
Applicant's Signature:

X_________________________________________________________ Date:_____________________________

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