Police Record Search Consent Form

POLICE RECORD SEARCH CONSENT FORM
The Oaks Apartments : 1300 West Tankbark Lane : Jackson, MI 49203 Phone: 517.782.2325 I understand that it is the Management Company's policy to obtain conviction criminal history information as part of their screening process. Using the information provided below, I consent to allow this company to obtain my conviction criminal history and agree that it is relevant to my application for housing.
ALL FIELDS ARE REQUIRED unless otherwise indicated.
Today's Date:
APPLICANT
First Name: Last Name: MI (optional): Sex (M/F): Email:
Social Security#: -- Birth Date: // Driver's License #: Issuing State:
Maiden Name and/or Name(s) Previously Used
First Name	Last Name
1:
2:
3:

ACKNOWLEDGEMENT
DIGITAL SIGNATURE By selecting "YES" below, I authorize Dahlmann Apartments, Ltd. as the managing agent for The Oaks Apartments, to utilize the information for the sole purpose of obtaining a conviction criminal history file search, and that this e-form may be used in lieu of an actual signature.
- Yes - No