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FORM #20 - Application Verification


Applicant Name: Date:

Credit report obtained, reviewed and attached: __Yes __No

Picture Identification: __Yes __No Type: _____________

Background report obtained, reviewed and attached: __Yes __No Notes: _________________________________________________

Current Employment Reference

Company Name: __________________ Telephone:_________
Address: ___________________________________________
Person spoken to: ________________
Date: _____ Time: ________ __a.m. __p.m.
Currently employed? __Yes __No Permanent/Full-time? __Yes __No
Applicant Salary:________

Other Income Verification

Source of Other Income:___________ Telephone:_________
Notes: ___________________________________________
Person spoken to: _____________________
Date: __________ Time: ________ __a.m. __p.m.
Will other income continue? __Yes __No If so, how long?_______
Other income amount__________

Landlord Reference

Current

Address: ___________________________________________
Person spoken to: ________________
Date: _____ Time: ________ __a.m. __p.m.
Date of last inspection? ______ Rent paid on time? __Yes __No
Tenant being evicted? __Yes __No Notices/Complaints? __Yes __No
Problems/Damages: ___________________________________________
Would you rent to this Tenant again? __Yes __No
If No, why? __________________________________
Did this Tenant have any pets? __Yes __No Did this Tenant smoke? __Yes __No
Other: ___________________________________________

Previous

Address: ___________________________________________
Person spoken to: ________________
Date: _____ Time: ________ __a.m. __p.m.
Date of last inspection? ______ Rent paid on time? __Yes __No
Tenant being evicted? __Yes __No Notices/Complaints? __Yes __No
Problems/Damages: ___________________________________________
Would you rent to this Tenant again? __Yes __No
If No, why? ___________________________________________
Did this Tenant have any pets? __Yes __No Did this Tenant smoke? __Yes __No
Other: ___________________________________________

Previous

Address: ___________________________________________
Person spoken to: ________________
Date: _____ Time: ________ __a.m. __p.m.
Date of last inspection? ______ Rent paid on time? __Yes __No
Tenant being evicted? __Yes __No Notices/Complaints? __Yes __No
Problems/Damages: ___________________________________________
Would you rent to this Tenant again? __Yes __No
If No, why? ___________________________________________
Did this Tenant have any pets? __Yes __No Did this Tenant smoke? __Yes __No
Other: ___________________________________________

Personal Reference

Name: ___________________________ Telephone: __________
Relationship: ________________ Date: ______ Time: ______ __a.m. __p.m.
Notes: ___________________________________________

Name: ___________________________ Telephone: __________
Relationship: ________________ Date: ______ Time: ______ __a.m. __p.m.
Notes: ___________________________________________

     

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1462 Commercial St. NE, Salem, OR 97301
Phone: 503-364-5468 | Fax: 503-585-8119

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