APPLICANT DISCLOSURE FORM

Pre-Screen Application APPLICANT DISCLOSURE FORM Please complete and E-mail (rentals@ironhorsemanagement.com) or Fax 228-385-9329. (Please call before fax) Address of Rental___________________________________________________________________________ Applicant’s Name___________________________________________________________________________ Day Phone___________________________________Home Phone___________________________________ Address___________________________________________________________________________________ City/State/Zip______________________________________________________________________________ Social Security Number______________________________________________________________________ Total Monthly Income_____________ Source of income: __________________________________ Date of Birth____________________ Driver’s License #/State________________________________________ I authorize Iron Horse Property Management & Investments {PMI} to obtain my consumer credit report and public records and to investigate any personal information on me necessary to arrive at an applicant decision. Signature___________________________________________________________Date______/______/______ Pre-screen application fee $35.00 ****WARNING/CONFIDENTIAL**** This message is intended for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is prohibited. If you have received this communication in error, please notify the sender by telephone immediately (808-778-5589). Thank you for your cooperation.

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