RENTAL VERIFICATION INFORMATION

TO: ________________________________________________

RE: _______________________________________________________

ADDRESS: ________________________________________________

RENTAL AMOUNT_________________________

LATE PAYMENTS Yes_________ No__________

NSF CHECKS Yes___________ No ____________

COMPLAINTS? _______________________________________________________________

_____________________________________________________________________________

TENANT HAS RENTED FROM _________ to __________

WAS PROPER NOTIFICATION GIVEN? Yes__________ No__________

WOULD YOU RENT TO THEM AGAIN? Yes__________ No__________

Pets? Yes__________ No__________

Storm Realty may verify any and all of the information provided by me for eligibility and release from liability all persons or entities supplying or collecting such information.