Pennsylvania Rental Application
This application is designed for prospective tenants in Pennsylvania. Please provide accurate information as it will be used to assess your eligibility to rent the property.
Personal Information
Full Name: _____________________________________
Date of Birth: _____________________________________
Social Security Number: ___________________________
Current Address: ___________________________________
City, State, Zip: ___________________________________
Phone Number: ___________________________________
Email Address: ___________________________________
Rental History
Current Landlord's Name: _________________________
Landlord's Contact Number: ________________________
Current Rent Amount: _____________________________
Previous Residences (Last 5 years)
- Address: ____________________________, Dates: ________________
- Address: ____________________________, Dates: ________________
- Address: ____________________________, Dates: ________________
- Address: ____________________________, Dates: ________________
- Address: ____________________________, Dates: ________________
Employment Information
Current Employer: ___________________________
Job Title: ____________________________________
Salary: ______________________________________
Employer's Address: __________________________
Employer's Phone Number: _____________________
References
- Name: ________________________, Relationship: _____________, Phone: ________________
- Name: ________________________, Relationship: _____________, Phone: ________________
Additional Information
Have you ever been evicted? Yes / No
Do you have any pets? Yes / No (If yes, please list: _______________)
Application Agreement
I certify that the information above is true and correct to the best of my knowledge. I authorize the landlord to conduct background checks, including credit history.
Applicant's Signature: _______________________________
Date: ____________________________