Certification and Authorization to Release Information





The Undersigned certify the following:


1. I/We have applied as a prospective tenant to Rollin' Home. In applying as such, I/We have completed an application containing personal information. I/We certify that all of the information contained in the application is true and correct. I/We certify that no misrepresentations were made on the application or any other supplementary materials or documents and that no pertinent information was omitted.


2. I/We understand and agree that Rollin' Home reserves the right to verify any and all information as provided in the application process, including verification of employment, credit history, and prior landlords.





To Whom It May Concern:


1. I/We, the undersigned, have applied as a prospective tenant to Rollin' Home. As part of the application process, Rollin' Home may verify personal information contained in my/our application and in supplemental information or documents required in connection with the application, either before any lease is signed or as part of any quality control program.


2. I/We authorize you to provide to Rollin' Home and all information and documentation that they request. Such information includes, but is not

limited to, employment history, income, credit history, rental history, including late or missed payments; a Consumer Credit Report and Criminal



3. Rollin' Home may address this authorization to any party named in the application or its supplemental documents.


4. A copy of this authorization may be accepted as an original.


5. Your prompt reply to any request from Rollin' Home is appreciated.


Note: Please fill out the fields marked with an asterisk.

Certification and Authorization Release Form
Here is downloadable version of the Credit Certification and Authorization form in case you would rather fax (423-926-4500) the form or deliver it to WILLOWRealty in person.
RH 3 Certification and Authorization.pdf
Adobe Acrobat Document 352.4 KB