Landlord Verification Form

    Date:

    Landlord Company Name:

    Tenant Information

    Tenant Name:

    Tenant Alias:

    Tenant Address:

    Notice Provided? YesNo

    Date of Notice:

    Move In Date:

    Move Out Date:

    Financial & Lease Details

    Rental Amount: $

    Security Deposit: $

    Housing Program? YesNo

    Co-payment Amount:

    Rent on Time? YesNo

    How many times late?

    Does Tenant Owe? YesNo

    How much?

    Legal & Conduct

    Broke the Lease? YesNo

    Have arrangements been made? YesNo

    Any Complaints? YesNo

    For what?

    Any Court Proceedings? YesNo

    Court Date:

    Any Judgments Filed? YesNo

    Explain:

    Bankruptcy filed by this person? YesNo

    Occupancy & Unit Condition

    Any Roommates? YesNo

    Names:

    Did Tenant have a Cosigner? YesNo

    Names:

    Over Occupied? YesNo

    Explain:

    Any Pets? YesNo

    Any Problems? YesNo

    Do you inspect during residency? YesNo

    Condition of unit during residency:

    Explain Condition:

    Final Verification

    Any Notices? YesNo

    For what?

    Would you re-rent? YesNo

    Comment:

    Authorization: By signing below, I authorize the release of requested information.

    Print Name:

    Position:

    Date:

    Signature (Type Name):

    Landlord Email:

    Applicant certifies the information provided on the application is accurate and truthful. Applicant understands Landlord Tenant Services and its subsidiaries will obtain a credit report, personal profile, and criminal background history. LTS is a third-party company that processes applications for members of Landlord Tenant Services. By signing this application, I authorize my employer, past employer, landlord, prior landlord, mortgage lender, bank, financial institution, credit union and personal references to release any information requested.