Rental History Verification Form - Rental Housing Network

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Rental History Verification
For Property Located at: _________________________________________________________________
To be completed by Applicant
Tenant Name: _______________________________________________________________________
I hereby authorize the release of information requested pertaining to my current or prior rental history.
Copies of this form may be provided for expediency.
___________________________________________
Tenant Signature
To be completed by current or prior Owner/Manager
Rental Address: ______________________________________________________________________
Dates of occupancy: From _________________ to _________________
Did you give the Applicant a notice to vacate? Yes ______ No ______
If yes, explain: _________________________________________________________
How many times during the past 12 months did the Applicant pay late? ____________
Does Applicant currently have any delinquent amounts owing? Yes ______ No ______
Have there been any neighbor complaints? Yes ______ No ______ If yes, how many? ______
If yes, explain: __________________________________________________________
Has there been any police activity? Yes ______ No ______
If yes, explain: __________________________________________________________
Did Applicant make any unauthorized repairs or alterations? Yes ______ No ______
Did Applicant move in any unauthorized adult occupants? Yes ______ No ______
Did Applicant damage any part of the property? Yes ______ No ______
If yes, explain: _________________________________________________________
Comments: _________________________________________________________________________
Information Provided by: _____________________________________ Title: ____________________
(print name)
____________________________________ Contact info: ___________________________
Signature:
(email or phone)
Please return form to requesting party:
__________________________________________
__________________________________________
__________________________________________
__________________________________________
Rental Housing Network, Inc. 2015
Rental History Verification
For Property Located at: _________________________________________________________________
To be completed by Applicant
Tenant Name: _______________________________________________________________________
I hereby authorize the release of information requested pertaining to my current or prior rental history.
Copies of this form may be provided for expediency.
___________________________________________
Tenant Signature
To be completed by current or prior Owner/Manager
Rental Address: ______________________________________________________________________
Dates of occupancy: From _________________ to _________________
Did you give the Applicant a notice to vacate? Yes ______ No ______
If yes, explain: _________________________________________________________
How many times during the past 12 months did the Applicant pay late? ____________
Does Applicant currently have any delinquent amounts owing? Yes ______ No ______
Have there been any neighbor complaints? Yes ______ No ______ If yes, how many? ______
If yes, explain: __________________________________________________________
Has there been any police activity? Yes ______ No ______
If yes, explain: __________________________________________________________
Did Applicant make any unauthorized repairs or alterations? Yes ______ No ______
Did Applicant move in any unauthorized adult occupants? Yes ______ No ______
Did Applicant damage any part of the property? Yes ______ No ______
If yes, explain: _________________________________________________________
Comments: _________________________________________________________________________
Information Provided by: _____________________________________ Title: ____________________
(print name)
____________________________________ Contact info: ___________________________
Signature:
(email or phone)
Please return form to requesting party:
__________________________________________
__________________________________________
__________________________________________
__________________________________________
Rental Housing Network, Inc. 2015

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