Rental History Verification Form
Property Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Tenant Name
First Name
Last Name
Tenant Name
First Name
Last Name
Applicant Authorization
Are you related to the applicant(s)?
*
Yes
No
Dates of Occupancy From
*
-
Month
-
Day
Year
Date
To
*
-
Month
-
Day
Year
Date
Rent Amount?
*
Were there any late payments in the last 12 months?
*
How many NSFs?
*
Does applicant currently have any delinquent amounts owed?
*
Yes
No
Did they give proper notice to vacate?
*
Yes
No
Other
If not, how much notice do you require to vacate?
Your Name and Title
*
First Name
Last Name
Title
Name of Company
*
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Date
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: