Applicant Last Name___  _____________________ Maiden/Prefix ________First _________Middle ________________ 

SSN__________    Date of Birth___________ Drivers License #_________________State Issued  _________________

Present Address ___________________________________City ___________ State_______________Zip___________

Unit #____ From  _______To________ Rent$ _____Landlord/Property Name________________ Phone #___________ 

Previous Address ___________________________City __________________State _______________ZIP_________ 

Unit # ____ From _______To__ ______Rent$ _____Landlord/Property Name ________________Phone #_________ 

(Only One Adult additional occupant. 2 Adults Max). Only ONE on Lease. NO joint Rentals.                       

Additional Occupants _______________ Emergency Contact and Number____________________________________  

Vehicle Make______________Mode _____________Year ________License # ______________________________         

Have You Ever filed Bankruptcy_____ Have you ever lived in another State? _____If yes, Which___________________ 

Have ever been Evicted or asked to Leave? _____ Have you ever refused to Pay Rent? _______

Have you ever been convicted of a Crime? _____ Do you have a legal Right to be in the United States?_____________ 

I am a US Citizen ____I have valid documentation from the US Department of Immigration and Naturalization Services

(INS) that allows me to be in the country. _____

 Authorization: I Authorize MRI soft ware/ Rental History Reports   whose address is 28925 Fountain Parkway Solon, OH 4139 USA ) To investigate my criminal history, residential, employment and income history, bank and credit history for the purpose of housing and /or employment. The source of information may come from, but is not limited to : Credit bureaus; banks and other depository institutions; current and former employers; federal and state records including State Employment and Security Agency records; county or state criminal records as follows, or other sources as required. It is understood that a photocopy or facsimile copy of this form will serve as an authorization. I understand failure to complete this form completely and truthfully may result in denial and/or forfeiture of deposit. This authorization is for this transaction only and continues in effect for one (1) year unless by state law, in which case the authorization continues in effect for the maximum period, not to exceed one (1) year, allowed by law. Note: Please return application with application fees to the client listed above.                  Signed __________________________________________________Date____________________Rental History Reports  28925 Fountain Parkway Solon, OH 44139 United States Phone 888-389-4023 or 952-545-3953 Fax 888-389-4024 or 952-545-3973 Email accountmanagement@rhris.com