Tenant

RENTAL APPLICATION
REQUIRED TO SUBMIT: $45 NON-REFUNDABLE FEE PER APPLICANT TO RUN CREDIT REPORT. MUST BE PAID VIA VENMO TO @MARYELLEN-DONATO IN ORDER TO PROCESS INFORMATION.
APPLICANT INFORMATION

Each Co-Signer must complete an application for the Property and will be considered an "Applicant" as defined in this form. If the application is approved and the parties enter into a lease, each Co-signer will be individually responsible for all of the obligations of the lease, including: rent, fees, damages and other costs. Co-signers will not have the right to occupy the Property as a tenant without Landlord's prior written permission.
The individual listed below is a(n):*

ApplicantCo-signer
Each Co-signer must complete an application for the Property and will be considered an “Applicant” as defined in this form. If the application is approved and the parties enter into a lease, each Co-signer will be individually responsible for all of the obligations of the lease, including rent, fees, damages and other costs. Co- signers will not have the right to occupy the Property as a tenant without Landlord’s prior written permission.

Applicant Information
Name*

First NameLast Name
Home Phone
Please enter a valid phone number.
Work Phone
Please enter a valid phone number.
Cell Phone*
Please enter a valid phone number.
Email*
example@example.com
How did you hear about this property?

PRIOR RESIDENCE INFORMATION

Provide two years of history.
Present Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County*
From*

MonthDayYear
Date
To*

MonthDayYear
Date
Rent/Mortgage*
Own / Rent / Other*

OwnRentOther
Landlord/Mortgage Co. Name
Landlord/Mortgage Co. Phone Number
Please enter a valid phone number.
Previous Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County (Previous Address)
From (Previous Address)

MonthDayYear
Date
To (Previous Address)

MonthDayYear
Date
Rent/Mortgage
Own / Rent / Other

OwnRentOther
Landlord/Mortgage Co. Name (Previous Address)
Landlord/Mortgage Co. Phone (Previous Address)
Please enter a valid phone number.

Include the full name of any other person not listed above who will be occupying the property:
Full Name

First NameLast Name
Is this individual 18 years of age or older?

YesNo
Full Name

First NameLast Name
Is this individual 18 years of age or older?

YesNo
Full Name

First NameLast Name
Is this individual 18 years of age or older?

YesNo

EMPLOYMENT INFORMATION

Provide at least two years of history. Attach additional sheets if more space is needed.
Current Employer*
Position*
Employed From*

MonthDayYear
Date
Employed To*

MonthDayYear
Date
City*
State*
Phone Number*
Please enter a valid phone number.
Name of Supervisor*
Gross Monthly Income*
Previous Employer
Position
Employed From

MonthDayYear
Date
Employed To

MonthDayYear
Date
City
State
Phone Number
Please enter a valid phone number.
Name of Supervisor
Gross Monthly Income
Upload Proof of Income:

Cancelof

Property Address
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County
Desire Lease Start Date

MonthDayYear
Date
Other Income Used For Monthly Expenses
Do you have other income used for monthly expenses? (Alimony, child support, or separate maintenance income need not be revealed if Applicant does not wish to have it considered as a basis for paying this obligation)*

YesNo

Bank Account Information

Please enter all bank accounts with information below.

	Bank Name	Account Type	Balance
1
2
3

Monthly Payments

Please enter all outstanding loans that you have. If you do not have any outstanding loans, please leave blank and hit next.

	Lender Name	Loan Type	Balance Due	Monthly Payment
1
2
3

Vehicles

Enter your vehicles below. Include any cars, trucks, vans, motorcycles, trailers, boats, and recreational vehicles. If you do not have any vehicles, please leave blank and hit next.

	Make / Model	Year	Color	License Plate / State
Vehicle 1
Vehicle 2
Vehicle 3

Does any Applicant or Occupant own any pets? (Guide and support animals not included)

YesNo
Is the pet an ESA or service animal?

YesNo

Pets

Please complete all questions for any pet that will be kept at the property.

	Type (dog, cat, etc.)	Breed	Gender	Weight	Age
Pet 1
Pet 2
Pet 3

Is Pet 1 Neutered or Spayed?

YesNo
Is Pet 2 Neutered or Spayed?

YesNo
Is Pet 3 Neutered or Spayed?

YesNo

CONDITION OF PROPERTY
The property will be leased in the same condition as it is shown unless otherwise provided in the lease.
APPLICATION FEE
The Application Fee is NON-REFUNDABLE and will not be applied towards rent or other financial obligations should Applicant be approved, nor refunded if not approved. Applicant agrees that this sum is paid in consideration of Landlord/Broker for Landlord’s review and/or verification of the information stated in the application.
OBLIGATION TO ENTER INTO LEASE AGREEMENT / DAMAGES
Upon submission of this Application, Landlord/Broker for Landlord reserves the right to remove property from the available rent list. If this Application is denied by Landlord, the Application Deposit shall be refunded to Applicant. If this Application is approved and Applicant fails to rent the Property, Landlord shall be entitled to retain the Application Deposit.
CONVICTED SEX OFFENDERS (MEGAN’S LAW)
The Pennsylvania General Assembly has passed legislation (often referred to as “Megan’s Law,” 42 Pa.C.S. § 9791 et seq providing for community notification of the presence of certain convicted sex offenders. Potential tenants are encouraged to contact the municipal police department or the

Pennsylvania State Police for information relating to the presence of sex offenders near a particular property, or to check the information on the Pennsylvania State Police Web site at www.pameganslaw.state.pa.us.
NOTICE TO PERSONS OFFERING TO SELL OR RENT HOUSING IN PENNSYLVANIA
(A) Federal and state laws make it illegal for Landlord, Broker, or anyone to use RACE, COLOR, RELIGION or RELIGIOUS CREED, SEX, DISABILITY (physical or mental), FAMILIAL STATUS (children under 18 years of age), AGE (40 or older), NATIONAL ORIGIN, USE OR HANDLING/TRAINING OF SUPPORT OR GUIDE ANIMALS, or the FACT OR RELATION- SHIP OR ASSOCIATION TO AN INDIVIDUAL KNOWN TO HAVE A DISABILITY as reasons for refusing to sell, show, or rent properties, loan money, or set deposit amounts, or as reasons for any decision relating to the sale of property. The municipality additional classes of individuals, such as gay, lesbian, bisexual and transgender individuals and couples. Broker and Landlord are advised to check with your local municipality, representative from the Pennsylvania Human Relations Commission, or your own attorney for further guidance. (B) The Fair Housing Act prohibits rental practices which have a discriminatory effect on members of protected classes, including outright bans on offering housing to individuals based on arrests or convictions without a case-by-case assessment of relevant mitigating factors. Consideration of an applicant’s criminal history must be limited to convictions and should include an evaluation of the nature and severity of the offense, the amount of time that has passed since the criminal conduct occurred, and whether denial of the application will serve a substantial, legitimate, nondiscriminatory interest. Selective use of an applicant’s criminal history as a pretext for intentional discrimination based on race, national origin, or other protected characteristics may be a violation of the Act, as well.
FAIR CREDIT REPORTING ACT
If the Landlord or Broker denies your application based in whole or in part on any information contained in the consumer report authorized by paragraph 16 of this Application, the Landlord or Broker must provide you with oral, written or electronic notice of the denial, and must provide to you: (1) the name, address, and telephone number of the consumer reporting agency (including a toll-free telephone number established by the agency if the agency compiles and maintains files on consumers on a nationwide basis) that furnished the report, (2) a statement that the consumer reporting agency did not make the decision to deny the application and is unable to provide you with the specific reasons why your application was denied, (3) a numerical credit score, the range of possible credit scores under the model used, up to four of the key factors that led to the denial, and the date the credit score was created (4) information about how to obtain a free copy of your consumer report from the consumer reporting agency, and (5) information about how to dispute the accuracy or completeness of any information in a consumer report furnished by the agency. If the Landlord or Broker denies your application because of information from a person other than a credit reporting agency (for example, an employer or prior landlord), the Landlord or Broker must provide you with notice about your right to make a written request to discover the nature of that information.

AUTHORIZATION
By initialing below, Applicant makes the following authorization(s):
Applicant authorizes Landlord or Broker for Landlord to obtain any information deemed necessary to evaluate this Application. This information may include, but is not limited to, credit reports, criminal history, judgments of record, rental history, verification of employment and salary, employment history, vehicle records, and licensing records. Broker for Landlord may report to Landlord any information obtained by Broker for Landlord for evaluation of the Application. Applicant acknowledges that all information in the Application is true and correct. Applicant acknowledges that if applicant presents false or incomplete information Landlord may reject this Application. Applicant understands that giving false or incomplete information may result in forfeiture of any payments made in connection with this Rental Application.*
Applicant understands and acknowledges that Applicant’s social security number, driver’s license number, date of birth, or other personal identifying information may be required in order for Landlord or Broker for Landlord to evaluate this application. If requested, Applicant agrees to provide the information on a separate form such as the Social Security Number Authorization PAR Form SSA Failure to provide this information may result in the denial of your application.*
Applicant agrees that Broker(s), his/her agent(s) and/or employee(s) may provide Applicant's social security number, individual taxpayer identification number, driver's license information and date of birth to lenders, title agencies, credit reporting companies, or others as necessary for obtaining reports or information from a credit reporting agency, determining the existence of domestic lines, or for obtaining a criminal background report (for prospective tenants only). Applicant understands that Brokers have no control over the use of any information after it is disclosed to a third party and agrees to release and hold Brokers harmless from any and all liability for any misuse or subsequent disclosure by any third party of the information or reports disclosed by Broker pursuant to the terms of this authorization.*
Applicant authorizes the Broker for the Landlord to contact the Applicant directly.*
I HAVE READ AND AGREE TO THE PROVISIONS AS STATED.
Applicant Signature*

Clear
DATE*

MonthDayYear
Date
APPLICANT NAME*
Applicant Social Security Number*
Date of Birth*

MonthDayYear
Date
Should be Empty:

	Source	Amout
1
2
3
4
5
6

RENTAL APPLICATION

APPLICANT INFORMATION

Applicant Information

PRIOR RESIDENCE INFORMATION

EMPLOYMENT INFORMATION

Property Address

Other Income Used For Monthly Expenses

Bank Account Information

Monthly Payments

Vehicles

Pets

Other Information

CONDITION OF PROPERTY

APPLICATION FEE

OBLIGATION TO ENTER INTO LEASE AGREEMENT / DAMAGES

CONVICTED SEX OFFENDERS (MEGAN’S LAW)

NOTICE TO PERSONS OFFERING TO SELL OR RENT HOUSING IN PENNSYLVANIA

FAIR CREDIT REPORTING ACT

AUTHORIZATION