I, the undersigned, declare all of the above-mentioned information to be true, and I hereby authorize any individual (private investigator, credit bureau, my employer, my current or former landlord) to disclose personal information about me to the lessor, or his representative or agent, in order to assess this rental proposal, or for any modification, renewal, or extension of my lease. It is understood that all information provided on this form or obtained by the landlord and/or his representative are confidential. I further agree to sign the lease form as long as the request is accepted in the next 10 days.