Application for Annual Residential Rental Certification

BOROUGH OF SCHWENKSVILLE

300 Main St., Schwenksville, PA 19473
APPLICATION FOR ANNUAL RENTAL REGISTRATION
Check one:*

Existing RentalNew Rental
Property Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Owner's Name*
Owner's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Does the owner live at this address?*

YesNo
Owner's Phone Number*
Please enter a valid phone number.
Phone Number (24 Hour Emergency Availability)*
Owner's Email*
example@example.com
Agent's Name & Company
Agent's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Agent's Phone Number
Agent's Email
example@example.com
Phone Number (24 Hour Emergency Availability)
Name of Rental Community (if applicable)
Is there an HOA?*

YesNo
Is the unit(s) registered with the HOA?*

YesNo
Number of Units Being Registered*
If multiple units are being registered, are they all in the same building?*

YesNo
Number of off-street parking spaces available?*
Total number of bedrooms?*
Type a question*

Individual Service Established through Borough contracted haulerCommunity Dumpster
Unit Designation (Example: A-1, #2)*
Name and Phone Number of Tenant(s)*
Second Unit Designation (Example: A-1, #2)
Name and Phone Number of Tenant(s)
Third Unit Designation (Example: A-1, #2)
Name and Phone Number of Tenant(s)
Fourth Unit Designation (Example: A-1, #2)
Name and Phone Number of Tenant(s)
Fifth Unit Designation (Example: A-1, #2)
Name and Phone Number of Tenant(s)
Sixth Unit Designation (Example: A-1, #2)
Name and Phone Number of Tenant(s)
I attest that all information submitted is accurate and that I will remit $25 per unit to the Borough by check or by paying online here.
Owner Name*
Owner Signature*

Clear
Date*

MonthDayYear
Date
Approving Initials
Should be Empty:

BOROUGH OF SCHWENKSVILLE

APPLICATION FOR ANNUAL RENTAL REGISTRATION