Bachand Group, Inc Application for Occupancy RHR- Rental History Reports
Administrative Office 701 5th Street South- Hopkins, MN 55343 722 Tower Ave, WI 54880 Phone: 888-389-4023 Fax: 888-389-4024
Phone: 715-718-0449 Fax: 715-718-3962 www.rentalhistoryreports.com
Applicant
Last Name______First Name______Middle_____ DOB______Social Security# - - Telephone#______
Spouse (only)
Last Name______First Name______Middle_____ DOB______Social Security# - - Telephone#______
Applicant Email______
Number of Household Members: Adults______18 and Older Children ______17 and Under
Dependent
Last Name______First Name______Middle_____ DOB______Social Security# - - Telephone#______
Dependent
Last Name______First Name______Middle_____ DOB______Social Security# - - Telephone#______
Dependent
Last Name______First Name______Middle_____ DOB______Social Security# - - Telephone#______
Dependent
Last Name______First Name______Middle_____ DOB______Social Security# - - Telephone#______
Number of Bedrooms Applying For: One______Two______Three______Four______Handicap Unit______
Are You Applying As A: Low Income Family ______or Elderly (62 or older), disabled, handicapped ______
Employment Info License Information
Applicant Work# ( ) _ Company Name______Applicant License#______State______
Spouse Work# ( )______Company Name______Spouse License#______State______
Household Annual Income $______
Have You Ever
Refused to Pay Rent When Due: Yes / No Filed for Bankruptcy: Yes / No Been Evicted: Yes / No
Been Convicted of a Crime: Yes / No If yes, Explain:______
Please Check Which Community You Would Like To Reside In. (Check all That Apply)
Golden ______Royalton Manor ______Superior Townhomes ______
Pine Avenue ______Highland Commons______North Meadows ______
Application for Occupancy
Addresses
Current______Apt#______From/To______City______State______Zip______
Landlord Information- Name ______Phone ______Address ______City______
State ______Zip ______
Previous______Apt#______From/To______City______State______Zip______
Landlord Information- Name ______Phone ______Address ______City______
State ______Zip ______
Previous______Apt#______From/To______City______State______Zip______
Landlord Information- Name ______Phone ______Address ______City______
State ______Zip ______
Authorization of Release
Signed Release
I authorize RHR Rental History Reports/Bachand Group, Inc. to do a complete investigation of all information provided above. I have personally filled in and/or reviewed all information above. I understand failure to complete this form completely and truthfully may result in denial. A complete investigation may include any or all of the following: Credit Report, Criminal Record, Rental History References (including MHPA) and Personal Interviews with the above references. I authorize RHR Rental History Reports to provide the credit grantor federal and state records of Employment, and Income History, including State Employment Security Agency records. This authorization is for this transaction only and continues for (1) year unless limited by state law, in which case that authorization continues in effect for the maximum period, not to exceed (1) year, allowed by law. My signature below authorizes all above listed companies to release companies to release Rental, Job History (including Salary) and Criminal Record Information.
______
Applicant Signature Date Spouse Signature Date
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