Resident Screening Order Form
Phone:  719-574-1887    fax:  719-574-3166
Date: ________________
Apartment/Company Name ____________________________
Contact __________________________________(must be an authorized user)
Applicant has issued me written instructions to obtain this information ______________ (initial)
Phone Number ________________       Fax Number ______________

     _________credit/criminal/eviction/sex offender

    

     __________criminal/eviction/sex offender

       _________credit report only           
           
       _________criminal report only  state _____________________________

       _________employment verification
            
       _________previous landlord verification
                        
       _________eviction report only
                                                                    

Monthly Income ________________(not required) Proposed  Rent __________________(not required)

Applicant ______________________________________________________SSN _______________________________  DOB _______________

Address ______________________________________________________________________________________________
                              Street                                                  City                      State          Zip (required)  

.                                

Co-Applicant ________________________________________________SSN ________________________________ DOB ___________________

Address ______________________________________________________________________________________________

If you receive this fax in error please destroy or contact us at the above number.