Authorization for Release of Information

Consent

I authorize and direct any Federal, State, or local agency, organization, business, or individual to release and verify my application to rent from Hager Rental. I understand and agree that this authorization or the information obtained with its use may be given to and used by Hager Rental in administering a thorough background check on me as a tenant. I also consent for Hager Rental to release information from my file about my rental history to credit bureaus, collection agencies, or future landlords. This includes records on my payment history and any violations of my lease or occupancy policies.

Information Covered

I understand that depending on Hager Rental policies and requirements, previous or current information regarding my household or me may be needed. Verifications and inquires that may be requested include but are not limited to:

Credit and Criminal Activity Medical or Child Care Allowances

Employment, Income and Assets Residences and Rental Activity

Identity and Marital Status

Group or Individual That May be Asked

The groups or individuals that may be asked to release the above information (depending on rental requirements) include but are not limited to:

Banks and other Financial Institutions Social Security Administration

Courts and Post Offices Utility Companies

Law Enforcement Agencies Welfare Agencies

Past and Present Employers Past and Present Landlords

Conditions

I agree that a photocopy of this authorization may be used for the purposes stated above. The original of this authorization is on file in the management office. I understand I have a right to review my file and correct any information that I can prove is incorrect.

Signatures

_______________________ _______________________ ___________________ _________

Head of Household (Print name) Social Security Date

_______________________ _______________________ ___________________ _________

Co-Head of Household (Print name) Social Security Date

_______________________ _______________________ ___________________ _________

Adult Member (Print name) Social Security Date

_______________________ _______________________ ___________________ _________

Adult Member (Print name) Social Security Date