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    Tenant Release and Consent Form (Tax Credit, HOME, RTC, Loan Compliance or Other Special Funding)

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    Chris Main
    The document is a tenant release and consent form allowing Jefferson County Housing Authority to verify information for a rental housing application. It authorizes the release of employment, income, rental history, and asset information from various individuals and organizations, including past and present employers, welfare agencies, veterans administration, previous landlords, retirement systems, social security administration, banks, child support providers, and medical providers. The consent is valid for twelve months and the tenant has a right to review and correct any incorrect information in their file.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Tenant Release and Consent Form (Tax Credit, HOME, RTC, Loan Compliance or Other Special Funding)

    Uploaded by

    Chris Main
    20 views1 page
    The document is a tenant release and consent form allowing Jefferson County Housing Authority to verify information for a rental housing application. It authorizes the release of employment, income, rental history, and asset information from various individuals and organizations, including past and present employers, welfare agencies, veterans administration, previous landlords, retirement systems, social security administration, banks, child support providers, and medical providers. The consent is valid for twelve months and the tenant has a right to review and correct any incorrect information in their file.

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    The document is a tenant release and consent form allowing Jefferson County Housing Authority to verify information for a rental housing application. It authorizes the release of employment, income, rental history, and asset information from various individuals and organizations, including past and present employers, welfare agencies, veterans administration, previous landlords, retirement systems, social security administration, banks, child support providers, and medical providers. The consent is valid for twelve months and the tenant has a right to review and correct any incorrect information in their file.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    20 views1 page

    Tenant Release and Consent Form (Tax Credit, HOME, RTC, Loan Compliance or Other Special Funding)

    Uploaded by

    Chris Main
    The document is a tenant release and consent form allowing Jefferson County Housing Authority to verify information for a rental housing application. It authorizes the release of employment, income, rental history, and asset information from various individuals and organizations, including past and present employers, welfare agencies, veterans administration, previous landlords, retirement systems, social security administration, banks, child support providers, and medical providers. The consent is valid for twelve months and the tenant has a right to review and correct any incorrect information in their file.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    7490 W 45th Ave

    Wheat Ridge, CO 80033


    303.422.8600

    TENANT RELEASE AND CONSENT FORM


    (Tax Credit, HOME, RTC, Loan Compliance or Other Special Funding)
    Christopher Main
    I/We, _______________________________________________________________________________________,
    the undersigned hereby authorize all persons all persons or companies in the categories listed below to release
    without liability information regarding employment, income, rental history, and/or assets to Jefferson County
    Housing Authority for purposes of verifying information on my/our rental housing application.

    INFORMATION COVERED

    I/we understand that previous or current information regarding me/us may be needed. Verifications and inquiries
    that may be requested include, but are not limited to: personal identity; employment history; income; assets, and;
    medical or child care allowances. I/we understand that this authorization cannot be used to obtain any information
    about me that is not pertinent to my eligibility for and continued participation as a qualified tenant.

    GROUPS OR INDIVIDUALS THAT MAY BE ASKED

    Past & Present Welfare Agencies Veterans Previous Landlords Retirement Systems
    Employers Administration (incl. Public Housing
    Agencies)
    Social Security Banks Support Child Support or Medical & Child Financial Institutions
    Administration Alimony Providers Care Providers

    CONDITIONS

    I/We agree that a photocopy of this authorization may be used for the purposes stated above. The original of this
    authorization is on file and will stay in effect for twelve months from the date signed. I/We understand I/we have a
    right to review this file and correct any information that is incorrect.
    Evergreen
    SIGNATURES for Apartment ______ Current Resident ( ) Applicant ( )
    Chris Main 04/28/2020
    _______________________________________________________________________________________
    Head of Household Print Name Date
    ________________________________________________________________________________________
    Spouse or Co-Head Date
    Print Name
    ________________________________________________________________________________________
    Adult Member Print Name Date
    ________________________________________________________________________________________
    Adult Member Print Name Date
    Note: This general consent may not be used to request a copy of a tax return. If a copy of a tax return is needed. IRS Form 4506. “Request for Copy
    of Tax Form, “must be prepared and signed separately.

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