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Authorization: Applicant authorizes Landlord and Landlord’s agent, at any time before, during, or after any tenancy, to:
(1) obtain a copy of Applicant’s credit report;
(2) obtain a criminal background check related to Applicant and any occupant; and
(3) verify any rental or employment history or verify any other information related to this application with persons knowledgeable of such information.

Notice of Landlord’s Right to Continue to Show the Property: Unless Landlord and Applicant enter into a separate written agreement otherwise, the Property remains on the market until a lease is signed by all parties and Landlord may continue to show the Property to other prospective tenants and accept another offer.

Privacy Policy: Landlord’s agent or property manager maintains a privacy policy that is available upon request.

Fees: Applicant submits a non-refundable fee of $

(entity or individual) for processing and reviewing this application.
will not submit an application deposit of $

to be applied to the security deposit upon execution of a lease or returned to Applicant if a lease is not executed.

Acknowledgement & Representation:

(1) Signing this application indicates that Applicant has had the opportunity to review Landlord’s tenant selection criteria, which is available upon request. The tenant selection criteria may include factors such as criminal history, credit history, current income and rental history.

(2) Applicant understands that providing inaccurate or incomplete information is grounds for rejection of this application and forfeiture of any application fee and may be grounds to declare Applicant in breach of any lease the Applicant may sign.

(3) Applicant represents that the statements in this application are true and complete.



have submitted an application to lease a property located
The landlord, broker, or landlord’s representative is:
(city, state, zip)

I give my permission:
(1) to my current and former employers to release any information about my employment history and income history to the above-named person;
(2) to my current and former landlords to release any information about my rental history to the abovenamed person;
(3) to my current and former mortgage lenders on property that I own or have owned to release any information about my mortgage payment history to the above-named person; (4) to my bank, savings and loan, or credit union to provide a verification of funds that I have on deposit to the above-named person; and
(5) to the above-named person to obtain a copy of my consumer report (credit report) from any consumer reporting agency and to obtain background information about me.

Note: Any broker gathering information about an applicant acts under specific instructions to verify some or all of the information described in this authorization. The broker maintains a privacy policy which is available upon request.