151 West Main Street Orange, Virginia 22960
Property Management (540) 672-2214
(540) 307-4955 (fax)
www.cowanrealty.net
EMPLOYMENT VARIFICATION REQUEST
The person below has applied for housing with Cowan Realty. Your cooperation in completing the
following questionnaire would be greatly appreciated.
PLEASE ANSWER THE FOLLOWING QUESTIONS
The undersigned hereby grants permission for Cowan Realty or its agents to verify my employment.
What property are you applying for? _____________________________________________
Applicants Name: _____________________________ Signature: __________________________
Date Employed: ___________________ to ____________________
Income: _____________________ per week month year (circle one)
Has this employee given or been given any notice to terminate present employment? NO YES
Company Name: ________________________________ Date: ______________________
Co-Applicants Name: _____________________________
Signature: ______________________
Date Employed: ___________________ to ____________________
Income: _____________________ per week month year (circle one)
Has this employee given or been given any notice to terminate present employment? NO YES
Company Name: ________________________________ Date: ______________________
Thank you for your cooperation in completing this form in a timely manner.
Rob Smith
Property Manager
Licensed Broker in State of Georgia
Licensed Broker in the Commonwealth of Virginia