MOMENTS REAL ESTATE
1301 N Gravel Pike, Perkiomenville, PA 18074
www.moments.realestate
(215) 237-7660
Lease Offer Details:
Agent Name
*
First Name
Last Name
Offer Deadline (if applicable)
-
Month
-
Day
Year
Date
Client #1 Name
*
First Name
Last Name
Client #1 Email
*
example@example.com
Client #1 Phone Number
Please enter a valid phone number.
Client #1 Current Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Client #2 Name
First Name
Last Name
Client #2 Email
example@example.com
Client #2 Phone Number
Please enter a valid phone number.
Client #2 Current Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Property Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Lease Start Date
-
Month
-
Day
Year
Date
Lease End Date
-
Month
-
Day
Year
Date
Name of Landlord(s)
Please list names of all occupants
Children or other occupants not named on the lease
Does the tenant have pets
Yes
No
Pet Deposit
Yes
No
Please select all utilities that would be tenant responsibility
Gas
Electric
Water/Sewer
Trash/Recycling
Lawncare and Snow maintenance
Oil
Appliances Included
Refrigerator
Microwave
Washer
AC units
Dryer
Monthly Rent
Security Deposit
First Months Rent Due By
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Month
-
Day
Year
Date
Last Months Rent Due By
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Month
-
Day
Year
Date
Security Deposit Due By
-
Month
-
Day
Year
Date
Settlement/Possention Date
-
Month
-
Day
Year
Date
Minimum Term
Example: 6, 12, 24 month lease
Is this rental apart of an HOA or Condo Association?
Yes
No
Compensation to Tenant's Broker
Any other info we need to know?
Submit
Should be Empty: