Rental History Form Template

Revised'08/06/13' ''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''RENTAL'HISTORY'
a t l a s r e a l t y m a n a g e m e n t c o., i n c. armco
RENTAL HISTORY
Date:________________________ From: Aspen Woods
1005 Aspen Woods Lane, Suite 1
To: _________________________ Attn: ______________________ Johnstown, PA 15904
Phone: (814) 266-2011
Phone: ______________________ Fax: _______________________ Fax: (814) 266-8917
www.aspen-woods.net
NAME(S): _______________________________________________________________________________________
ADDRESS: _______________________________________________________________________________________
The above person(s) has applied for tenancy (or is a resident) at Aspen Woods. The applicant/resident herein authorizes the release of
information regarding his/her rental history. The information you provide will be used for the purpose of determining the household’s
eligibility for tenancy. We are required to complete our verification process in a short-time period and would appreciate your prompt
response. If you have any questions, please contact our office.
Please complete the section below and return to this office via U.S. mail or you may fax (listed above)
Requested by: Karen Sroka, President
To be completed by Landlord/Homeowner:
Are you related to the applicant? Yes No If yes, explain: _________________________________________________
Length of residency:________________________________ Rental Amount: $________________________ per month
Did tenant pay on time? Yes No If No, reason: ___________________________________________________________
Did tenant leave owing back-rent or unpaid charges? Yes No If Yes, explain: __________________________________
Check any problems encountered: Noise Unsupervised Children Chronic Complaints
Housekeeping Property Destruction Bedbugs
Other _________________________________________________________
Was a security deposit required? Yes No Do you know of any charges that will be withheld from the Security
Deposit? Yes No If Yes, explain: __________________
Is a vacating notice required? Yes No ______________________________________________________
Has a vacating notice been given? Yes No
Your overall recommendation of tenant while residing at your property: Excellent Good Fair Poor
Comments: _______________________________________________________________________________________________
_________________________________________________________________________________________________________
I certify that the above information is true and correct.
_____________________________________________ ______________________________________________________
Landlord’s Name (Print) Landlord’s Name (Signature) Date
APPLICANT/TENANT RELEASE: I hereby authorize the release of the requested information. Information obtained under this consent
is limited to information that is no older than 12 months.
____________________________________________________ ___________________________________________
Signature Date
____________________________________________________ ___________________________________________
Signature Date
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Rental History Form Template PDF

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