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RHOL Business Membership Application

Company Name _______________________________ Address ____________________________

City_____________________________ State_____ Zip ____________

BILLING ADDRESS (If different)

Company Name _______________________________ Address ____________________________

City_____________________________ State_____ Zip ____________

Name of principal ____________________Title _____________Soc. Sec. No, __________________

Years in business ____Federal Tax ID # ________________________________________________

Business License or State Registration number __________________________________________

Name of Subsidiary/Parent/Affiliated Co._________________________________________________

Address__________________________ City _________________State _____Zip________

GENERAL INFORMATION

Indicate the specific business purpose for which credit information will be used (e.g., tenant screening):

__________________________________________________________________________________

Number of Rental Units________ Estimated Monthly Inquiries________

Please list all authorized users: _________________________________________________________

REFERENCES

Name of Bank________________________________________ Branch ________________________

Checking Account #___________________________________Phone #( _____ )_________________

Street Address _____________________________City _____________________St. ___ Zip_______

Business Reference:

Company________________________ Street _______________City ___________St ____Zip______

Account # ____________Phone # ______________ Contact Person ____________________________

Company________________________ Street _______________City ___________St ____Zip______

Account # ____________Phone # ______________ Contact Person ____________________________

I certify that the above information is accurate and give Rental Housing On Line (RHOL) permission to verify all references:

Signature _________________________________________ Date_____________

Type or Print Name and Title_________________________________________

You must include a signed copy of a RHOL SERVICE AGREEMENT with this application.