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Order Credit Report
Credit Report Order Authorization
CREDIT REPORT/BACKGROUND CHECK AUTHORIZATION AND PRIVACY DISCLOSURE FORM

I hereby authorize and instruct SECURITY REAL ESTATE to obtain and review my credit report/background. My credit report/background will be obtained from a credit reporting agency chosen by SECURITY REAL ESTATE. I understand and agree that SECURITY REAL ESTATE intends to use the credit report for the purpose of evaluating my rental ability.
Who`s Your Showing Agent?
Showing Agent Name?*

1st Credit Report
First Name:*

First Name:*

Middle Initial:

How Many Credit Reports?
Last Name:*

SSN #:*

Phone #*

Home Address:*

City:*

State:*

Zip:*

Email:*

2nd Credit Report
First Name:

Middle Initial:

Last Name:

SSN #:

Phone #

Home Address:

City:

State:

Zip:

Email:

3rd Credit Report
First Name:

Middle Initial:

Last Name:

SSN #:

Phone #

Home Address:

City:

State:

Zip:

Email:

4th Credit Report
First Name:

Middle Initial:

Last Name:

SSN #:

Phone #

Home Address:

City:

State:

Zip:

Email:

5th Credit Report
Card Brand:*

First Name:

Middle Initial:

Last Name:

SSN #:

Phone #

Home Address:

City:

State:

Zip:

Email:

How Many Credit Report Ordered?
How Many Credit Reports?:*
 T
CVV3:*

Grand Total:
GRAND TOTAL
Credit/Debit Card Information
Phone #:*

Name On Card*

Card Address*

City*

State:*

Zipe Code*

Card Brand*

Credit Card #*

Card Exp.*

CVV3#*

Cardholder Agreement
By signing this form, I authorize SECURITY REAL ESTATE to charge my credit card for the above charges. The Total Amount Shown Above In Compliance With The Cardholder Agreement
Signature:*

Dated:*

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