Applicant Consent Form For Pre-Employment Or Tenant Screening Investigation & Specific Release

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Nextgen Management Services DBA. Listings Center
Applicant Consent Form for Pre-Employment or Tenant Screening Investigation & Specific Release
I certify and declare under penalty of perjury under relevant state and federal law that the information contained in
my employment/leasing application is complete, true, and accurate. I acknowledge that falsification or omission of
information may result in immediate dismissal or retraction of any offer of employment/lease.
In consideration of ____________________________ ‘s (herein referred to as voluntarily consent to and authorize
EMPLOYER/LANDLORD, or its authorized agents bearing this release or copy thereof, to obtain a consumer
report for employment/leasing purposes. I agree that this consumer report may include any of the following:
Employment Verification, Education Verification, credentials Verification
Personal Identity Verifications, Past Employment Verification, Reference Checks
Criminal Records, Civil Cases, Motor Vehicle Records, Credit Report
I authorize all persons and organizations that may have information relevant to this research to disclose such
information to EMPLOYER/LANDLORD or its authorized agents. I hereby release EMPLOYER/LANDLORD,
its authorized agents, and all persons and organizations providing information from all claims and liabilities of ant
nature in connection with this research. I hereby further authorize that a photocopy of this authorization may be
considered as valid as the original.
I understand that I have specific prescribed rights as a consumer under the federal Fair Credit Reporting Act
(‘FCRA’) and may have additional rights under relevant state law. I hereby certify that I have been presented with a
summary of my rights as a consumer under the Fair Credit Reporting Act.
_______________________________________
______________________
Signature of Applicant
Date
Printed Name ___________________________________________
____________________________________________
Address
__________________________
_____________
_________________
City
State
Zip Code
___________________
______________________
Date of Birth
Social Security Number
Driver’s License Number # and State of issue
_________________________________________________

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