Fill and Sign the Signed Print Name Form

SALARY VERIFICATION FORM FOR POTENTIAL LEASE OR LOAN [This form to be completed and mailed to business or person addressed below in order to verify current compensation rate of applicant.] To: _________________________ [applicant’s employer] Address: To: _________________________ [potential lessor/lender] Address: [Applicant’s name]: _________________________ has indicated, in an application for lease/loan, that he/she is employed by you. Please provide the following information in reference to his/her employment: 1. Date employment began: ____________________ 2. Position held: _____________________________ 3. Annual pay: _____________________________ 4. Hourly rate (if applicable): __________________ Applicant has consented to your verification of the requested information and, as evidenced by applicant’s signature below. Thank you for your assistance and prompt return of this verification form in the enclosed stamped envelope. Sincerely, ______________________________ [potential lessor/lender] CONSENT I, [print applicant’s name]: _________________________________ hereby consent to the release of my salary/compensation information by my employer, as indicated above, to the entity or person indicated above. This the ____ day of _______________, 20____. Signed: ___________________________ Print name: ____________________________ (applicant’s signature) [Sender: Enclose self-addressed, stamped envelope for use by applicant’s employer to return this verification to you.]