____________________________________ 

[Management Agent Letterhead] 

EMPLOYMENT VERIFICATION 

To: _______________________________________ Date: 

___________________________ 

_______________________________________ 

_______________________________________ 

_____________________________________________ has applied for residency/ is a 

resident at _______________________________________. As part of our processing, it is 

necessary that we obtain verification of his/her employment and anticipated GROSS annual 

income. The attached release and consent form authorizes the release of information 

regarding the applicant's employment and income. 

Please complete the section below and return it in the enclosed self-addressed 

stamped envelope. (Please mail rather than have the above individual hand deliver.) Thank 

you in advance for your prompt attention. 

Sincerely, 

(Apartment Manager) 

THE FOLLOWING TO BE COMPLETED BY EMPLOYER: 

Anticipated Gross Income for the Next Twelve Months 

Hourly $____________ Weekly $____________ 

No. of hours per week_____ 

Bi-weekly $____________ Monthly$____________ 

Overtime: Average per $____________ $____________ 

$___________________ 

Day Week Month 

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Tips, Commissions, Bonuses: 

Average per $____________ $____________ $___________________ 

Day Week Month 

Year $______________ 

- or ­

Total anticipated gross annual income for the next twelve months (including tips, bonuses or 

overtime if applicable) $_________________________. 

Employer's Signature	 Date 

(____)_________________________________

 Title Telephone 

WARNING:	 Section 1001 of Title 18 of the U.S. Code makes it a criminal offense to make willful false statements 

or misrepresentations to any Department or Agency of the United States as to any matter within its 

jurisdiction. 

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__________________________________________________________________ 

________________________ 

_____________________________________________________________________ 

__ 

_____________________________________________________________________ 

_________________________ 

[Management Agent Letterhead] 

ASSET VERIFICATION 

Name and
 

Address of Bank: 

RE: __________________________________ SSN: 

Applicant/Tenant Name 

Applicant/Tenant Address City, State Zip Code 

The above person(s) has applied for tenancy/is a resident at 

________________________________. As part of our processing we require 

verification of the household's income, expenses and other information related to 

eligibility. The individual has authorized below your release of the required information.

 The information you provide will be used only for the purpose of determining the 

household's eligibility for tenancy. We are required to complete our verification 

process in a short time period and would appreciate your prompt response. If you have 

any questions, please feel free to contact our office. 

Permission by: 

(Applicant) (Date) 

Please complete the section below and return it in the enclosed self-addressed 

stamped envelope. (Please mail rather than have the above individual hand deliver.) 

Thank you in advance for your prompt attention. 

Sincerely, 

(Apartment Manager) 

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TO BE COMPLETED BY INSTITUTION 

CHECKING ACCOUNT 

Account Number(s) Average 6 Month Balance(s) 

__________________ $ ________________________ 

____________________% 

__________________ $ ________________________ 

____________________% 

__________________ $ ________________________ 

____________________% 

Interest Rate, If Any 

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__________________ 

__________________ 

__________________ 

__________________ 

__________________ 

__________________ 

Account Number(s)

Account Number(s)

Present Account 

Balance(s) Rate 

$______________ 

$______________ 

$______________ 

TRUST 

Value of Trust Fund Administered: 

Anticipated Amount of Income to be earned by
 

Trust over next 12 months: 

ASSET VERIFICATION 

PAGE 2 

SAVINGS ACCOUNT 

Present Account 

Balance(s) Rate 

$______________ 

$______________ 

$______________ 

Annual Interest Withdrawal 

Penalty 

___________% __________ 

___________% __________ 

___________% __________ 

CERTIFICATE OF DEPOSIT 

Annual Interest Withdrawal 

Penalty 

___________% __________ 

___________% __________ 

___________% __________ 

$ __________________________ 

$ __________________________ 

PROPERTY
 

Value of Equity in Real Property $ __________________________ 

I certify that the above information is true and correct. 

________________________________________ ______________________________ 

Name of Official Title of Official 

________________________________________ ______________________________ 

Name of Institution Signature 

________________________________________ ______________________________ 

Address Date 

________________________________________ ______________________________ 

City, State, Zip Code Telephone Number 

WARNING:	 Section 1001 of Title 18 of the U.S. Code makes it a criminal offense to make willful 

false statements or misrepresentations to any Department or Agency of the United 

States as to any matter within its jurisdiction. 

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TENANT INCOME VERIFICATION FORM 

Documentation of Telephone Verification 

Tenant Name: ______________________________ Date: _______________________ 

Address: ______________________________ 

_____________________________________________ has applied for residency/is a resident at 

_______________________________________. This form documents employer's verification of his/her 

employment and gross annual income. 

INCOME REPORT BY: 

Anticipated Gross Income for the Next Twelve Months 

Hourly $____________ Weekly $____________ 

No. of hours per week_____ 

Bi-weekly $____________ Monthly $____________ 

Overtime: Average per $____________ $____________ $_____________ 

Day Week Month 

Tips, Commissions, Bonuses: 

Average per $____________ $____________ $_____________ 

$__________ Day Week Month 

Year 

- or ­

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_________________________________________ 

_________________________________________ 

_________________________________________ 

_______________________________________ 

_______________________________________ 

Total anticipated gross annual income for the next twelve months (including tips, bonuses or overtime 

if applicable) 

$_________________________. 

Name of Employer 

Contact Person 

Title 

Date and Time 

(________)_____________________________ 

Telephone 

Management Staff (Signature) 

WARNING:	 Section 1001 of Title 18 of the U.S. Code makes it a criminal offense to make willful false 

statements or misrepresentations to any Department or Agency of the United States as to any 

matter within its jurisdiction. 

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