I/we, the undersigned, authorize Fidelis Screening Solutions, LLC, Landlord and its agents to obtain an investigative consumer
credit report including but not limited to credit history, OFAC search, landlord/tenant court record search, criminal record
search and registered sex offender search. I authorize the release of information from previous or current landlords,
employers, and bank representatives. This investigation is for resident screening purposes only, and is strictly confidential.
This report contains information compiled from sources believed to be reliable, but the accuracy of which cannot be
guaranteed. I hereby hold Fidelis Screening Solutions, LLC, Landlord and its agents free and harmless of any liability for any
damages arising out of any improper use of this information.
Important information about your rights under the Fair Credit reporting Act:
• You have a right to request disclosure of the nature and scope of the investigation.
• You must be told if information in your file has been used against you.
• You have a right to know what is in your file, and this disclosure may be free.
• You have the right to ask for a credit score (there may be a fee for this service).
• You have the right to dispute incomplete or inaccurate information. Consumer reporting agencies must correct
inaccurate, incomplete, or unverifiable information.
These reports are being processed by Fidelis Screening Solutions, LLC, 4534 Clinton St. Ste. 2, West Seneca, NY 14224.
A summary of your rights under the Fair Credit Reporting Act is available by visiting (Para information en espanol, visite o
escribe): http://www.consumerfinance.gov/learnmore or writing Consumer Financial Protection Bureau, 1700 G Street N.W.,
Washington, DC 20552
Applicant agrees to pay a non-refundable application fee of: $___________
(Signed/Applicant) Date
