Dakota Management Services

Prior Landlord and Credit Report Authorization Letter

Landlord’s Name: Dakota Management Services / Adam David

Address:  P.O. Box 603

City, State, Zip:  Holyoke, MA 01041

            I hereby give the above landlord the right to obtain a credit report, criminal background check, and any other information regarding me and I release from all liability all persons, companies and corporations supplying such information.  I indemnify the above landlord against any liability which might result from making such investigations.

            I understand that any false answers, statements, or implications made by me in this application or other required documents shall be considered sufficient cause for denial of this rental lease application.

Applicant’s Name:  _____________________________________________________________

Second Applicant’s Name: _______________________________________________________

Address:  _____________________________________________________________________

City, State, Zip:  _______________________________________________________________

Applicant:             SSN#: _______-_____-__________            D.O.B. ________/_______/___________

2^nd Applicant:       SSN #: _______-_____-__________            D.O.B. ________/_______/___________

Signed By:

____________________________________________          ____________________________

Applicant                                                                                     Date

____________________________________________           ____________________________

Second Applicant                                                                        Date

Witnessed By:

_____________________________________________