RENTON OFFICE

234 SW 43rd St, Ste MA

Renton, WA 98057

Office: (206) 973-3500

Fax: (206) 577-5090

Email:

The content of this form is for informational purposes only and does not constitute legal advice. Do not use our firm name in these forms. Communications through this website, document, or directly with an attorney in this firm do not constitute an attorney-client relationship, and no such relationship will be established without an executed retainer agreement. Any representations are not guaranteed to be accurate, current, or complete. If you are a current client, please contact the firm prior to using these forms. This law firm does not offer any guarantee of case results. Past success in litigation does not guarantee success in any new or future lawsuit.

APPLICANT BACKGROUND SCREENING NOTICE

To: ______

SCREENING/CREDIT REPORTING AGENCY

Name:______Phone:______

Address:______

PLEASE READ THE FOLLOWING STATEMENT AND AGREE TO THE TERMS OF THE BACKGROUND CHECK BY SIGNING BELOW:

You are being charged $__.__ for a Background Screening of your tenant application. Screening your application includes calling your former landlord, employers and financialinstitutions.

You hereby consent to have an investigation made relating to statements made on your application and/or questionnaire, and consent to have such information as may be received reported to our credit reporting agency.

You also agree to provide any information which may be required in reference to any past history and authorize each person, firm, credit bureau, company, corporation, governmental agency, court, financial institutions, employer, police department, motor vehicle department, licensing agency, schools, colleges, universities, and any other association or institution having control of any documents, records and/or information pertaining to the information needed to fulfill the background screening, to furnish to our credit agency or any of its designated agents any such information, background reviews, driving records, employment records, including documents, records, files containing charges or complaints filed, formal or informal, pending or closed, or any other pertinent data, and to permit our credit screening agency, or its agents to inspect and make copies of such documents, records and other information.

You further authorize to furnish any documentation requested by interested landlords, management companies, and/or employer(s) and their authorized agents a report relating to statements made in this application. By signing the application for tenancy, you have authorized these individualsand/or agencies to release information to us so that we can evaluate your application.

We use the above named agency to provide both credit and other information with regard toyou and your application. If we deny you tenancy based on information provided by theabove named agency, you have the right to contact the agency by telephone (listed above)to determine and/or dispute the accuracy of the information they have provided.

We are not required to release or disclose information provided to us by the agency, except as required under the Federal Fair Credit and Reporting Act. If you seek to reviewyour credit reports or other such information, you should contact the AGENCY listed abovedirectly.

Your signature below acknowledges that you have received a copy of this Notice.

Date:______Landlord/Agent:______

Date: ______Applicant:______

1