Instructions: Applicant please fill out Section 1 (Authorization To Release Information), sign, fax or email back to office. APPLICANT DO NOT FILL OUT SECTION 2 we will send to your current/prior Landlord.
To Whom it May Concern, I, blanks (applicant name) have applied for tenancy at blank (property address that you are applying for), and herby give permission to my Landlord to release the following information to, Philadelphia Real Estate or its authorized agent, in connection with his/her tenancy at (current address).
Amount of rent due per month: blanks Has the applicant ever paid late? Please Select No Yes . If so how many times? Start & End Date of current or prior lease: Start Date: Date End Date: Date Is the applicant's account paid in full to date? Please Select Yes No Has legal action ever been taken against applicant? Please Select Type Option 1 Type Option 2 Type Option 3 If yes, explain: Type a label Additional Comments By Landlord: Type a label Landlord/or Agent Name: First Name Last Name Phone Number: Area Code Phone Number
Once submitted this form will be sent to your currect Landord by Philadelphia Real Estate to be completed. We will not accept a completed form by an applicant.