Pennsylvania Rental Application Form

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The Pennsylvania Rental Application is a form provided to a prospective lessee from a lessor for the purposes of determining their eligibility as a tenant. Prospective tenants will be required to enter personal information into the application form that will allow the landlord to review their reliability and trustworthiness as a tenant. The landlord is looking to check employment and rental history (as well as references related to both), credit scores, criminal history, and other pertinent information. Once the applicant(s) complete the form, the lessor will have provided the tools needed to determine the best possible lessee for your property.

Application Fee (No Statute) – No limit to the amount a landlord can charge for an application fee; fees are non-refundable.

Security Deposit (§ 511.1(a)) – No landlord may ask for a security deposit amount in excess of two months’ rent.

How To Write

Step 1 – Download the document and

  • Enter the amount of the application fee in the field provided
  • Read all of the information at the top of the pager

Step 2 – Applicant Information – Enter the following:

  • Full Name
  • Is applicant at least 18 years old? (check yes or no)
  • Social Security Number
  • Date of Birth
  • Driver’s License or ID Number
  • State
  • Home Phone
  • Work Phone
  • Cell Phone
  • Bank/Credit Union
  • Account Number
  • Account Type
  • Emergency Contact
  • Relationship
  • Phone Number for Emergency Contact

Step 2 – Residential Information – Provide a two year history

  • Current Address (check rent or own)
  • From what date
  • To what date
  • Rent/mortgage per month
  • Landlord/Mortgage Company Name
  • Phone
  • AND
  • Prior Address
  • From what date
  • To what date
  • Rent/mortgage per month
  • Landlord/Mortgage Company Name
  • Phone

Step 3 – Employment Information – Two year history

  • Employer
  • Position
  • Address
  • Supervisor
  • Phone
  • Supervisor
  • Gross Income monthly
  • OR
  • Hourly Pay
  • How many hours per week on average
  • Employed From What Date to What Date
  • AND
  • Previous Employer
  • Position
  • Address
  • Supervisor
  • Phone
  • Supervisor
  • Gross Income monthly
  • OR
  • Hourly Pay
  • How many hours per week on average
  • Employed From What Date to What Date

Step 4 – Other Income –

  • Name the sources of other income (if any)

Step 5 – Vehicle Information for each vehicle –

  • Make
  • Model
  • Year
  • Color
  • Plate Number

Step 6 – Other Occupants – Enter

  • The full name of each occupant
  • Check the box if the occupant is 18 or older

Step 7 – If you have pets –

  • List each pet
  • Describe each pet

Step 8 – Other (Miscellaneous) Information:

  • Have you ever declared bankruptcy or suffered foreclosure?
  • Have you ever been evicted or sued for unpaid rent or damages to leased property?
  • Have you ever refused to pay rent for any reason?
  • Have you ever been convicted of a felony or misdemeanor?
  • Have you been obligated to pay support under an order, on record in Pennsylvania, since January 1, 1998?
  • If Yes – List the County and the Domestic Relations File or Docket Number
  • Amount
  • Are you delinquent?
  • If you’ve answered “yes” to any of the above- provide an explanation

Step 9 – Provide Personal References –

  • Name
  • Phone Number
  • Address
  • If you would like to provide additional comments enter them in the lines provided

Step 10 – Authorization –

  • Applicant(s) must carefully review and agree to all of the information in the paragraph
  • Applicant’s Signature
  • Date the signature

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