Pennsylvania Rental Application Form

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The Pennsylvania Rental Application is a document that is provided to a prospective lessee from a lessor so that they may provide information that is needed to determine whether or not the prospective lessee would be a reliable client for the property that is available for rent. Prospective tenants will be required to provide information that is verifiable. Provision of this information will allow a lessor to check personal and professional references, rental history, their employment history,  they will likely ask for permission to run a credit checks and possibly a criminal background check. Once the applicant(s) complete the form, the lessor will have provided the tools needed to determine the best possible lessee for your property.

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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