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Tenant Authorization and Release for Rental History Verification

Applicant Name:

Current Property Address/Unit:

I, the undersigned, do hereby authorize
to completely and accurately answer these questions. I hereby release them from any liability for the answers provided.

Note to current/previous landlord: please complete and fax back to Impero Property Management at 602-535-3176. You can also email us at application@imperopm.com. Thank you.

Tenant move in date: MoveIn
Tenant move out date: MoveOutDate
Any other persons on lease? If so, please provide names:
Any pets? If so, please describe:
Current rent amount per month: $ /mo
Was the term of the lease fulfilled? LeaseTermFulfilled YesNo

If lease was not fulfilled, date tenant vacated? DateVacated
Did tenant provide proper notice? Notice YesNo

Did tenant NSF? NSF YesNo

Did tenant pay late? Late YesNo

Was tenant the subject of a forcible detainer? Forcible YesNo

If so, reason for forcible detainer: ForcibleReason Non-payment of rent Irreparable breach Abandonment Other

Other reason:
Did tenant violate any community policies? Violate YesNo

Was the tenant’s deposit or any portion thereof withheld due to damage to the property? Damage YesNo

Was the tenant sent to collections? Collections YesNo

What was the condition of the property upon move out?
Would you rent to this tenant again? RentAgain YesNo

Comment:
I, ____ , a duly authorized representative of do hereby swear and affirm that the following is accurate and complete to the best of my knowledge.

I, the undersigned, do hereby authorize my current landlord
to completely and accurately answer these questions. I hereby release them from any liability for the answers provided.

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Your email address

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Timestamp

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January 19, 2016 10:44 am MST

Tenant Authorization and Release for Rental History Verification Uploaded by Nick Bucchino - nick@impero-property.com IP 160.3.206.100