Have you rented from any other companies?
RELEASE OF ADDRESS (LOCATION) INFORMATION TO OUT THE DOOR RENT TO OWN
The undersigned below hereby consent(s) to the release of information concerning my (our) address or location to Out The Door Rent To Own. In particular, this release shall permit the disclosure to Out The Door Rent To Own of such information regarding the undersigned in the possession of any agency or department of any state government of the United States of America, or of any other person or agency, or my (our) current or past employer. This release shall be effective for 24 months from the date below. I (we) understand that certain state and federal laws exist which protect my (our) right to privacy by restricting access to state and federal agency files, or files held by third parties. My (our) digital signatures below indicate that I (we) have knowingly and voluntarily waived the protection of state, federal and common law right to privacy laws for the limited purpose of providing address information to Out The Door Rent To Own.
READ STATEMENT BEFORE SIGNING.
I certify that the information supposed by me on this form is true and correct. I authorize verification of the truthfulness of all information contained herein, included contact with any person for firm listed above, and fully release all parties from any liability for any damage that may result. Any false statement made above be sufficient basis for rejection of this order. I have read and understand the statement printed on this form. If this order is rejected, I may request the reasons(s) for same by sending a self-addressed, stamped envelope requesting the reason(s) to the store manager.