Employer Consent Form V3

Van Mildert Landlord & Tenant Protection Ltd First Floor DCS House Silverbirch Camperdown Ind. Est. Newcastle Upon Tyne NE12 5UJ

Van Mildert Employment Reference Consent Form I, the undersigned, hereby give my consent to my employer Employer Name ______________________________________ to release any and all information held about me to a representative of Van Mildert Landlord & Tenant Protection Limited (Van Mildert) upon their request, for the purposes of an Employment Reference Check.

Signed _____________________________________________ Print Name __________________________________________ Date _______________________________________________

Van Mildert Landlord and Tenant Protection Limited is authorised and regulated by the Financial Services Authority. Registered in England number 7064255. Registered office address: DCS House, Silverbirch, Camperdown Industrial Estate, Newcastle Upon Tyne, NE12 5UJ.