5616 W 74th St, Indianapolis, IN, 46278 |
Address I Am Applying to
--- Select Property ---
1021 N. Berwick Ave.,Indianapolis,IN,46222
3532 Moller Rd. ,Indianapolis ,IN,46224
Date of Birth
Expected Moving Date
Current Landlord Name
Current Landlord Phone#
Reason for Leaving
Occupants and Pets Details
Pets (Monthly Pet Fees Will Apply)
Employer Contact Name
Employer Phone #
Current Monthly Salary
Proof of Income:
I/we, the undersigned, authorize Triarii LLC, Landlord and its agents to obtain an investigative consumer credit report including but not limited to credit history, OFAC search, landlord/tenant court record search, criminal record search and registered sex offender search. I authorize the release of information from previous or current landlords, employers, and bank representatives. This investigation is for resident screening purposes only, and is strictly confidential. This report contains information compiled from sources believed to be reliable, but the accuracy of which cannot be guaranteed. I hereby hold Triarii LLC, Landlord and its agents free and harmless of any liability for any damages arising out of any improper use of this information.
Important information about your rights under the Fair Credit reporting Act:
You have a right to request disclosure of the nature and scope of the investigation.
You must be told if information in your file has been used against you.
You have a right to know what is in your file, and this disclosure may be free.
You have the right to ask for a credit score (there may be a fee for this service).
You have the right to dispute incomplete or inaccurate information. Consumer reporting agencies must correct inaccurate, incomplete, or unverifiable information.
A summary of your rights under the Fair Credit Reporting Act is available by visiting or writing (Para information en espanol, visite o escribe):
Consumer Response Center, Room 130-A, Federal Trade Commission, 600 Pennsylvania Avenue N.W., Washington D.C. 20580
Consumer Report Disclosure and Authorization
In connection with my application for housing, I understand that the property owner/agent may obtain one or more consumer reports, which may contain public information, for the purposes of evaluating my application. These consumer reports will be obtained from one or more of the following consumer reporting agencies:
Equifax, E.C.I.F., P.O. Box 740241, Atlanta, GA, 30374-0241, (800) 685-1111
Trans Union, Regional Disclosure Center, 1561 Orangethorpe Ave., Fullerton, CA, 92631, (714) 738-3800
Experian (TRW), Consumer Assistance, P.O. Box 949, Allen, TX, 75002, (888) 397-3742
These consumer reports are defined as investigative consumer reports. These reports may contain information on my character, general reputation, personal characteristics and mode of living. In connection with my application for housing, I authorize owner/agent to obtain a consumer report from the consumer reporting agencies listed above.