PAYMENT VERIFICATION FORM
This form applies to payment verification for leases as well as common charges and maintenance charges for cooperative and condominium properties. If you are a current or former resident requesting verification of payment history complete only the Resident Information portion of the form. Please note that we can only provide verifications for residents who are the tenant of record.
Companies requesting a payment verification letter for a current or former resident must fill out the Resident Information and Company Information below. You must also provide an authorization letter signed by the resident in order for us to process the request. You may attach a scanned copy using the form below or fax it to (212) 210-6674.
All verification letters will be sent electronically, either to the email address provided for the resident or the requesting firm. There is a $75 service charge for all verification letters. After submitting your information below, you will be directed to a payment screen. Your request cannot be processed until the payment has been submitted.
RESIDENT INFORMATION
First Name: *
Last Name: *
Building Address: *
Unit number: *
Email Address: *
COMPANY INFORMATION
Requesting firm name:  
Contact first name:  
Contact last name:  
Email Address:  
Resident authorization (attachment upload):  
Clear selectionBrowse...
Continue
Payment Information
Card Number: *
payment_method
Expiration Date: *
xv
xv
Security Code: *
Billing First Name: *
Billing Last Name: *
Billing Address: *
Billing City: *
Billing State: *
xv
Billing Zip: *
Billing Phone: *
Email: *
Payment Amount:   $75
*
I hereby authorize Rose Associates, NovelPay, LLC and its agents to charge the above credit card a non-refundable fee in the amount above, and I agree to pay all charges in accordance with the terms of my cardholder statement.
Back
Pay
Error
Thank you. Your request and $75 payment has been confirmed.

Your request will typically be processed in 2 business days.
Return to Rose Associates Homepage
Back