LIBERTY PROPERTY MANAGEMENT

Phone: (614) 557 7128

INFORMATION VERIFICATION AGREEMENT
This agreement made and concluded this ____ day of______, 2017 by and between
LIBERTY PROPERTY MANAGEMENT , hereafter " Owner" and
______,hereafter "Applicant"
Applicant's printed name
For and in consideration of the promises and covenants contained herein, the parties agree as follows
1. The Applicant shall pay to the Owner a nonrefundable fee upon the execution of this Agreement in the
amount of $35 to cover the administrative costs. expenses and time of the Owner to verify the information
submitted by the Applicant to determine whether or not the Owner will or will not rent premises owned or
controlled by the Owner to the Applicant.
2. Applicant authorizes the Owner, his employees, agents or representatives to make any and all inquires
necessary to verify the information provided herein, including but not limited to, direct contact with Applicant’s
employer, past employers, landlord, prior landlords, credit, credit bureau, neighbors, police agencies and any and all
other sources of information which the Owner may deem necessary and appropriate within his sole discretion.
3. The Application represents to the Owner that all the information provided for herein is true, accurate and
complete to the best of Applicant's knowledge and further, agrees that if any such information is not as represented,
then Applicant may, at the Owner's sole discretion, be disqualified as a tenant.
4. The Applicant provides the following information to the Owner:

APPLICANTNAME: LAST ______FIRST ______MIDDLE______

SSN______-_____- ______BIRTH DATE ______/______/______

DRIVERSLICENSESTATE ______D.L. NUMBER ______EXPIRATION ______

CURRENT TELEPHONE NUMBER ( ) ______IS THIS YOUR TELEPHONE: YES OR NO

CURRENT ADDRESS: NUMBER ______STREET ______APT. NO ______

CITY______STATE ______ZIP CODE ______

NAME OF LANDLORD ______TELEPHONE NUMBER ( )______

WHEN DID YOU MOVE IN? ______RENT PAID NOW $ ______

HAVE YOU GIVEN NOTICE? YES OR NO HAVE YOU BEEN ASKED TO LEAVE ? YES OR NO

MAY WE CALL YOUR LANDLORD/MANAGER YES OR NO

WHY ARE YOU MOVING ? ______

IS THE TOTAL MOVE-IN AMOUNT AVAILABLE NOW ( THE FIRST MONTHS RENT AND DEPOSIT)? YES OR NO

HAVE YOU EVER BEEN EVICTED? YES OR NO IF YES, WHEN? ______

HAVE YOU EVER BEEN CONVICTED OF A FELONY? YES OR NO

CONTINUED

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EMPLOYER______TELEPHONE NUMBER: ( ) ______
OCCUPATION ______HIRE DATE ______
SUPERVISOR ______SARLAY ______YEAR / MONTH / WEEK / HOUR
FULL-TIME? YES OR NO IF PART TIME, HOW MANY HOURS PER WEEK? ______

LIST BELOW THE NAMES AND RELATIONSHIPS OF ALL PERSONS TO OCCUPY PREMISES:

NAME / RELATIONSHIP / NAME / RELATIONSHIP

OWNER IS NOT LIABLE TO THE APPLICANT, HIS HEIRS, EXECUTORS, ADMINISTRATORS OR ASSIGNS FOR ANY DAMAGE OF ANY KIND, ACTUAL OR CONSEQUENTIAL BY REASON OF THE VERIFICATION BY THE OWNER OF THE INFORMATION PROVIDED BY THE APPLICANT AND, APPLICANT HERE BY RELEASES THE OWNER HIS AGENT, EMPLOYESS AND/ROR REPRESENTATIVES FORM ANY AND ALL ACTIONS, CAUSES OF ACTION OF ANY KIND OR NATURE THAT MAY ARISE BY VIRTUE OF THE EXECUTION OR IMPLEMENTATION OF THE AGREEMENT PROVIDED HEREIN.

APPLICANT HAS SET HIS/HER HAND ON THE DATE FIRST WRITTEN ABOVE AND ATTESTS TO THE VALIDITY OF INFORMATION PROVIDED AND FURTHER AGREES TO PERMIT LIBERTY PROPERTY MANAGEMENT TO PERFORM CREDIT CHECKS.,

______

Applicant's Authorizing Signature

COMPLETE FOLLOWING IF YOU HAVE LIVED AT CURRENT ADDRESS LESS THAN ONE YEAR:

PREVIOUS ADDRESS: NUMBER______STREET ______APT. NO ______

CITY______STATE ______ZIP CODE ______

NAME OF LANDLORD______TELEPHONE NUMBER ______

WHAT RENT DID YOU PAY ? ______WHEN DID YOU MOVE IN? ______

WHEN AND WHY DID YOU MOVE OUT? ______

The property ______, rents for $740 per month. Rent does not include electric or water. Tenant must arrange and pay for this service.

THIS DOCUMENT IS ONLY A RENTAL APPLICATION WHICH INCLUDES CREDIT CHECK AUTHORIZATION AND IS NOT A RENTAL AGREEMENT. A RENTAL AGREEMENT WILL BE REQUIRED TO BE COMPLETED BY AN ACCEPTED TENANT.