Background Tenant Screening Information Form Page 2
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2Address History
Please provide a complete address history since the age of 18.
Address
City / State / Zip
County
Dates
Address
City / State / Zip
County
Dates
Address
City / State / Zip
County
Dates
Address
City / State / Zip
County
Dates
Address
City / State / Zip
County
Dates
Address
City / State / Zip
County
Dates
I hereby certify that all information provided in this authorization is true, correct and complete. I understand
that if any information proves to be incorrect or incomplete, that is grounds for the canceling of any or all
offers of occupancy that may exist and may be used at the discretion of ___________________________.
Signed this ____________ day of ______________, 20________
Applicant (Print Name):
Applicant Signature:
Background Screening by C4 Operations, Inc. | 1-888-519-6283 |
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Parent category: Medical