Background Investigation – Authorization Form

1

Today's Date* This field is required.

Date

2

PLCA Unit/Lot:* This field is required.Ex: D-4 or Lot 32

3

Unit Owner/Landlord's Name* This field is required.

First Name

Last Name

4

Applicant's Mailing Address* This field is required.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

5

Will Lot/Unit Be Rented?* This field is required.

Yes

No

6

Rent Amount* This field is required.

7

National Criminal Report

I/We hereby allow TENANT SCREENING NOW and/or the property owner/manager to inquire into my/our criminal, rental, and employment history. I/We cannot claim any invasion of privacy against them now or in the future.

8

Applicant Relationship Status* This field is required.

Single

Married

Married to Co-Applicant

9

Applicant Social Security Number* This field is required.

10

Applicant Full Name* This field is required.

First Name

Middle Name

Last Name

11

Applicant Date of Birth* This field is required.

Date

12

Current Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

13

Applicant Email Address* This field is required.

example@example.com

Email Verified

The verification code has been sent to some@email.com
Please check your mailbox and paste the code below to complete verification

••••

14

Applicant Phone Number* This field is required.

15

Applicant Current Landlord Name* This field is required.

16

Applicant Current Rent Amount* This field is required.

What will be your Rent Amount per Month

17

Applicant Current Employer* This field is required.

Who do you work for

18

Applicant Occupation* This field is required.

Sales, Retail, Transportation

19

How Long has Applicant been at Current Job* This field is required.

How many Years and Months - Example 3yrs 4mo

20

Applicant Work Phone Number* This field is required.

Please enter a valid phone number.

21

Applicant Supervisor's Name* This field is required.

Who is your Boss

22

Has Applicant EVER had an Eviction?* This field is required.

Yes

No

23

Applicant Driver's License Number* This field is required.

24

Applicant Driver's License Issuing State* This field is required.

25

Upload Front of Applicant Driver's License Here* This field is required.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

26

Applicant Signature* This field is required.

Powered by Jotform SignClear

27

Is there a Co-Applicant?* This field is required.

Yes

No

28

Co-Applicant Information

29

Co-Applicant Relationship Status

Spouse

Roommate

Co-Signer

30

Co-Applicant Full Name

First Name

Middle Name

Last Name

31

Co-Applicant Social Security Number

32

Co-Applicant Date of Birth

Date

33

Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

34

Co-Applicant Email Address

example@example.com

Email Verified

The verification code has been sent to some@email.com
Please check your mailbox and paste the code below to complete verification

••••

35

Co-Applicant Phone Number

36

Co-Applicant Current Landlord Name

37

Co-Applicant Current Rent Amount

What will be your Rent Amount per Month

38

Co-Applicant Current Employer

Who do you work for?

39

Co-Applicant Occupation

Sales, Retail, Transportation

40

How Long has Co-Applicant been at Current Job?

How many years and Months - Example 3yrs 4 mo

41

Co-Applicant Work Phone Number

Please enter a valid phone number.

42

Co-Applicant Supervisor's Name

Who is your Boss?

43

Has Co-Applicant EVER had an Eviction?

Yes

No

44

Co-Applicant Driver's License Number

45

Co-Applicant Driver's License Issuing State

46

Upload Front of Co-Applicant Driver's License Here* This field is required.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

47

Co-Applicant Signature* This field is required.

Powered by Jotform SignClear

48

Please verify that you are human* This field is required.

49