Rental History Verification

Rental History Verification

Please complete this form to verify a tenant's rental history. All information should be accurate and complete.
Tenant Information
Full Name*

First NameLast Name
Current Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email Address*
example@example.com
Landlord/Property Manager Information
Name*

First NameLast Name
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email Address*
example@example.com
Rental Property Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Move-in Date*

MonthDayYear
Date
Move-out Date

MonthDayYear
Date
Monthly Rent Amount*
Paid on timePaid lateOwes balanceNo late payments
YesNo
If yes, please describe the lease violations.
Reason for Leaving
YesNo
Additional Comments
Signature of Landlord/Manager*

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Date Signed*

MonthDayYear
Date
Should be Empty: