Manassas Meadows Rental Application (Page 3 of 3) in pdf

Manassas Meadows Rental Application Page 3

THE HOLLADAY CORPORATION

AUTHORIZATION FOR RELEASE OF INFORMATION

FOR PROPER PROCESSING,

THIS FORM MUST BE FILLED OUT

BY APPLICANT COMPLETELY

Leaseholder ________

LAST NAME:__________________________________________M.I._______________

FIRST NAME:___________________________ Date of Birth: ______/______/_______

Social Security Number: __________________________Male ______Female_________

Street Number: _____________Street Name: ___________________________________

Street Type (Ln, Rd, St, Cir, Ave) ________ Apt #: ______ Current Rent: $ ________

City: ________________________________ State: __________ Zip Code: ___________

I do hereby authorize a review and full disclosure of all of my records, including, but not

limited to, credit history, civil and criminal background information, records of arrest,

rental history, employment/salary details, vehicle records, licensing records, and/or any

other financial or background

information concerning myself by/to any authorized

personnel of THE HOLLADAY CORPORATION; or companies owned by or affiliated

with, THE HOLLADAY CORPORATION (“Landlord Representatives”). I agree to

indemnify and hold harmless the Landlord Representatives, the person to whom this

request is presented and his/her agents and employees from and against all claims,

damages, losses and expenses, including reasonable attorney’s fees arising out of or by

reason of complying with this request. The intention of this authorization is to provide

the landlord Representatives with access to as much information as possible that will be

utilized for the approval or disapproval of the rental application with MANASSAS

MEADOWS APARTMENTS (A Holladay Corporation Property)

Date: ____/____/____

Signature:__________________________________________

Witness Signature: __________________________________

10230 G Manassas Mill Rd

703-369-6898 Phone / 703-330-9103 Fax

EQUAL HOUSING OPPORTUNITY

Manassas, VA 20110

Manassas Meadows Rental Application Page 3