POLICE RECORD SEARCH CONSENT FORM

South Glen Apartments : 19400 South Glen Blvd : Brownstown Township, MI 48183
Phone: 734.675.4100

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
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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 South Glen 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.

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