Applicant Screening Authorization Form printable pdf download

APPLICANT SCREENING AUTHORIZATION FORM 05/16

(Please print clearly)

Please remember to have your applicants print neatly to reduce mistakes and typos.

All fields (except previous address) are REQUIRED! Reports will not be run unless filled out completely

*ONE FORM PER PERSON, PLEASE, OR IT WILL BE REJECTED*

Applicant Full Name: _______________________________________________________________________________________

(First, middle, last)

Social Security Number: _____________________________________ Date of Birth: ___________________________________

Combined monthly income of all applying: ___________________ # of months at current position: _______________________

Current Address: ________________________________________________________________________ Since: ____/____/____

(Street, city, state, zip)

Previous Address: _______________________________________________________________________ Since: ____/____/____

(Street, city, state, zip)

I certify that the above information is correct and complete and hereby authorize you to make inquiries you feel necessary to evaluate

my tenancy and credit standing, including but not limited to, a check of my credit. I understand that if I am denied tenancy due to my

credit standing, I have the right to dispute the accuracy or completeness of any information in the credit report.

Applicant Signature: _______________________________________________________________________

_____________________________________________________________________________

Rental Owner

Monthly Rent for Unit (required): ____________________

_____________________

Membership Name:

Member ID #: _________________________________

: ____________________________

Submitted By

Complex: ______________________________________

Phone Number: ____________________________________________ Fax Number: ___________________________________

Reports must be kept in the strictest confidence. If you choose to deny this applicant, the applicant may request a copy of the reports

and has a right to receive them. By signing below I agree to only screen applicants for the purposes of residential tenancy.

I will not e-mail this form or any other personal, financial or confidential information.

Membership Signature: ______________________________________________________________________________________

Decision Point

Landlord Verification



(Application to rent required)



DPC Combo Report

2-3 days to process



(Includes Decision Point and Oregon & Washington

Criminal History in Oregon & Washington – Statewide



-Statewide Criminal)

(Includes violations through Federal offenses such as sex

Tenant Performance & Eviction History



offender records)

Credit Report

Nation-Wide Criminal Report



(

Only if approved through NTN)

(Includes information from all 50 states!)

Decision Point Plus



Nationwide Sex Offender Search



Social Security Search



Employment Verification

(Application to rent required)



Criminal Search in a single county anywhere in the US



2-3 days to process

(Surcharges could apply; standard processing time is 1-2 weeks.)

*PLEASE INDICATE YOUR PREFERENCE:

Phone & Pick-up _____ Phone & FAX_____ Phone & MAIL_____ Fax ONLY____

Applicant Screening Authorization Form

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