Employment and Salary Verification Form
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Employment and Salary Verification Form

Employment and Salary Verification Form

To Whom it May Concern:

We are in the process of verifying information provided by , who is applying for an apartment in our building. To complete the application process, we must verify the employment/income information that was provided by on his or her application. Information contained on this form will be used in accordance with the Fair Credit Reporting Act. has provided his or her consent for you to provide the requested information, as verified by his or her signature below.

To be completed and signed by the applicant

Last Name: First Name: Middle Name: Social Security Number:
___________________________ ______________________ _____________________ ________ - _______ - __________
Current Address: City: State: ZIP Code:
___________________________ ______________________ _____________________ _____________________________


I hereby authorize my employer to provide employment and compensation information to the landlord or landlord's agent. I hold both the landlord and my employer harmless for any claims against them for filling out, commenting on, or discussing this form and its subject matter.

Tenant Signature: ________________________________ Date: ________________


To be completed and signed by the applicant's employer (supervisor or HR)

Employer Name: Telephone No.:


Employer Address: City: State: ZIP Code:
____________________________________ ____________________________ __________ ________________________

Which of the following best describe the employment status of the applicant?

[  ] Current employee

[  ] Former employee

[  ] Never an employee
[  ] Full-time employee

[  ] Part-time employee

[  ] Temporary employee
Avg. Number of Weekly Hours Worked:_____________

Date of Hire (mm/yyyy):

Job Title:
______________________________________ ___________________________

Salary: $______________
[  ] Hourly

[  ] Weekly

[  ] Bi-weekly

[  ] Yes  $______________

[  ] No
Your Name: Your Title: Your Telephone No.:




Signature: ________________________________ Date: _________________

Thank you in advance for your assistance in this matter. Please email the completed document to me at .



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