Citi Credit Bureau

LANDLORD APPLICATION

PRINT-COMPLETE-SIGN-FAX TO 714-441-0087

Name__________________________________________________________Date_____/_____/_______

Firm Name (If Applicable)_____________________________Type of Business____________________

Address___________________________________City_________________State______Zip__________

E-mail Address________________________________________________________________________

Phone #__________________________________Fax #_______________________________________

(Please Complete One of the Following) Social Security #____________________________________or

Drivers License #___________________________or Federal Tax ID #___________________________

I will be ordering [   ] Tenant Credit Reports,  [   ] Basic Tenant Package,  [  ]Full Tenant Package

 [   ] Eviction Report [   ] Criminal Records [   ] Driving Records [   ] Other

Credit Card you wish Billed?      [   ] Visa  [   ] Master card

Name of Cardholder__________________________ Last 3 number (back of card)___________

Credit Card #__________________________________________Expiration Date__________________

Card Billing Address _______________________________ ZiP_____________________

I agree to comply and abide with the Fair Credit Reporting Act in its entirety. I also agree to the terms of the (included) Security Access Requirements Agreement. I agree to obtain an executed application from each applicant stating consent to view their consumer credit report and will keep the executed application confidentially on file for at least two years. I will not disclose any such information to any other party or resell any information provided to me by Citi Credit Bureau.

Signature______________________________________________________Date_____/_____/_____

Landlords

Address of Rental Property_______________________________________________________________

City_______________________State______Zip__________County(Not Country)__________________

Citi Credit Bureau   Phone 714-441-0083 Fax 714-441-0087