Complete Your Custom ORHA Rental Form

shopping cart

Please Fill In the Form



Required entries are indicated by blue icons or *


Your application to rent the property did not meet our screening guidelines for the following reasons:

Screening Charge Returned: 

Because your application did not meet our standards, we are:

You have the right to request from us, in writing within 60 days of receiving this letter, the nature of that information.

The consumer reporting agency that provided the report was:

CBI Equifax Credit Information
PO Box 105851
Atlanta, GA 30348

Experian (formerly TRW)
PO Box 2002
Allen, TX 75013

Trans Union Consumer Relations
PO Box 1000
Chester, PA 19022

While the consumer reporting agency listed above provided information about your credit or history, it took no part in making the decision regarding your application, nor can it explain why adverse action was taken.

Under the Fair Credit Reporting Act (15 USC 1681j), you have the right to obtain a copy of your consumer credit report. To obtain a free copy, you must request it within 60 days of the date you receive this letter by writing or telephoning the consumer reporting agency checked above. You may also go to www.annualcreditreport.com to view all three of your credit profiles free of charge.

If you believe any information in your report is incorrect, you have the right to dispute the accuracy or completeness of the information and to put into your report a consumer statement of up to 100 words explaining your position on the item under dispute. Trained personnel are available to help prepare consumer statements.

You also have certain rights under credit reporting and consumer protection laws in Oregon. For further information, you should contact a consumer protection agency or the Attorney General's office.


Please Note: Signature field must be filled in and signed after printing.

Owner/Agent Signature:   Date:

  • Click "Preview Form" below to check your information.
  • If the form is correct, close the preview to return to this page, then click "Generate PDF". Your form will be created and added to your cart.
  • From your cart, you can return to the Forms Store to create more forms, delete forms from your cart or purchase the items in your cart.

© 2019 Oregon Rental Housing Association - All Rights Reserved
1462 Commercial St. NE, Salem, OR 97301
Phone: 503-364-5468 | Fax: 503-585-8119
eMail: forms@oregonrentalhousing.com

Powered by Wild Apricot Membership Software