Pennsylvania Rental Application

Sources
Amounts
$
$
Pennsylvania Rental Application
TO APPLICANT
This application must be completed in full. If “None”, so indicate. All items are subject to verification. A false or willfully omitted statement in this
application will be grounds for its rejection, or the cancellation of your lease at the option of Landlord.
This application must be accompanied by a fee of $ for processing and credit reports. This fee is not refundable.
Landlord
Phone No.
Property Address
1. APPLICANTS
Apt. No.
Date
Name
Social Security No.
Date of Birth
Name
Home Phone
Business Phone
Marital Status
Driver’s License No.
Pets (Special written permission required)
Children’s Names and Ages
Why are you moving?
Present Rent
Utilities
2. LAST THREE RESIDENCES
Present Address, City and State =ip Code
Dates of Occupancy
Landlord’s Name, Address, Phone No.
Previous Address, City and State
Previous Address, City and State
3. EMPLOYMENT
Supervisor’s Name
Present Employer
Address and Phone No.
Zip Code
Dates of Employment
Previous Employer
4. EMPLOYMENT OF SPOUSE
Supervisor’s Name
Present Employer
Address and Phone No.
Zip Code
Dates of Employment
Previous Employer
5. LIST OF MOTOR VEHICLES
Do You Desire Garage Rental?
Yes
No
Make
Year
Color
Type
License No. and State
Previous Employer
6. LIST OF YOUR PROPERTY
WHICH WILL BE LOCATED ON THE RENTAL PREMISES
7. MONTHLY INCOME
Items
Value
Furniture
$
TVs, Stereos, Radios, etc.
Total
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Pennsylvania Rental Application PDF

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