Fillable Ownmanapb Owners Manual Appendix B

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Ownmanapb Owners Manual Appendix B

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(YOUR COMPANY LETTERHEAD)
TENANT RELEASE AND CONSENT
I/We _____________________________________________________, the undersigned hereby
authorize
_______________________________________________________, to release without liability,
information
(employer or other source)
regarding my/our employment, income, and/or assets to ______________________________________,
(owner or agent)
for purposes of verifying information provided as part of my/our apartment rental application.
INFORMATION COVERED
I/We understand that previous or current information regarding me/us may be needed. Verifications and
inquiries that may be requested include, but are not limited to: personal identity; employment, income, and assets;
medical or child care allowances. I/We understand that this authorization cannot be used to obtain any information
about me/us that is not pertinent to my eligibility for and continued participation as a Qualified Tenant.
GROUPS OR INDIVIDUALS THAT MAY BE ASKED
The groups or individuals that may be asked to release the above information include, but are not limited
to:
Past and Present Employers Welfare Agencies Veterans Administration
Previous Landlords (including State Unemployment Agencies Retirement Systems
Public Housing Agencies) Social Security Administration Banks and other Financial
Support and Alimony Providers Medical and Child Care Providers Institutions
B-1
_______________________________
_______________________________
_______________________________
_______________________________
______________________________
______________________________
______________________________
______________________________
_____________________________
_____________________________
_____________________________
_____________________________
CONDITIONS
I/We agree that a photocopy of this authorization may be used for the purposes stated above. The original
of this authorization is on file and will stay in effect for a year and one month from the date signed. I/We
understand I/we have a right to review this file and correct any information that I/we can prove is incorrect.
SIGNATURES
Head of Household
Spouse
Adult Member
Adult Member
(Print Name)
(Print Name)
(Print Name)
(Print Name)
Date
Date
Date
Date
NOTE: THIS GENERAL CONSENT MAY NOT BE USED TO REQUEST A COPY OF A TAX RETURN. IF A
COPY OF A TAX RETURN IS NEEDED, IRS FORM 4506, "REQUEST FOR COPY OF TAX FORM" MUST BE
PREPARED AND SIGNED SEPARATELY.
B-2
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Ownmanapb Owners Manual Appendix B

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Completed 1 July 2020

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