Rental Application Form And Applicant/resident Release And Consent Form (Page 2 of 3) in pdf

Rental Application Form And Applicant/resident Release And Consent Form Page 2

APPLICANT/RESIDENT

RELEASE AND CONSENT FORM

In consideration of Coastal Properties of Va. review of my rental/renewal application, I hereby voluntarily

consent to and authorize Coastal Properties of Va. to obtain information with regards to my qualification as a

resident of this apartment community.

I/We authorize all persons and organizations that may have information relevant to my residency to disclose

such information to Coastal Properties of Va. Inc. I hereby further authorize that a photocopy of this

authorization may be considered as valid as the original which will be on file and will remain in effect for one

(1) year from the date signed.

GROUPS OR INDIVIDUALS WHO MAY BE ASKED TO RELEASE INFORMATION:

Past & present employers

Welfare agencies

Previous & present landlords

Police department official records

State unemployment agencies

Educational institutions

Child support & alimony providers

Social Security Administration

Veterans Administration

Retirement systems/administrations

Medical & childcare providers

Credit bureaus

Banks & other financial institutions

Applicant/Resident Signature

Print Name

Date

Co-Applicant/Resident Signature

Print Name

Date

Other Adult Member of Household

Print Name

Date

Other Adult Member of Household

Print Name

Date

Coastal Properties of VA April 2010 Revised

Tax Credit Form #38

Rental Application Form And Applicant/resident Release And Consent Form Page 2