AUTHORIZATION FOR FILE DISCLOSURE

We are pleased to answer your request for disclosure of your Tenant Data Rental History Report. You may obtain one free tenant history report per calendar year. If you have been denied residency or suffered another adverse action within the last 60 days, you may request a free tenant history report after each adverse action.

First Name

Middle Name

Last Name

SSN

DOB

Contact Phone Number

Address Information

Present Street Address

City

State

Postal Code

In accordance with the FCRA, proper identification is required. Tenant Data requires 2 forms of identification, which will be used to verify your identity to ensure you get a complete and correct report. The primary ID must include both a permanent picture and a signature and must not be expired. The secondary ID must include a signature and must not be expired. Common acceptable forms of identification are:

Primary Identification: Driver’s license, state id card, passport, military id, employee id, school id

Secondary identification:Social Security Card, Debit/ATM Card, Credit Cards, a second form of ID from the Primary list

Please be prepared to upload copies of these forms on the 2nd page of this Submission Form.

Preferred Delivery

Please Indicate how you would like your report delivered to you.
Email
U.S. Mail

Tenant History Entitlement

I am requesting my FREE ANNUAL Tenant History Report.
I am requesting my entitlement to a copy of the Tenant Data report pulled in the last 60 days because ADVERSE ACTION was taken.
I am requesting my entitlement to a copy of the Tenant Data report pulled in the last 60 days - NO adverse action was taken.

Signature

I hereby acknowledge receipt of “A Summary of your Rights Under The Fair Credit Reporting Act”, and a list of Federal agencies responsible for enforcing my rights under the FCRA. I further acknowledge that I may have additional rights under state or local laws and that I have been informed that I may wish to contact a state or local consumer protection agency to learn about my rights. I hereby state and represent that the information in this application is complete and accurate. I certify that I am the person named above and that I am submitting this request for my own file disclosure.

A Summary of Your Rights

Applicant Signature

Date