Pennsylvania Rental Application
This rental application is designed for individuals seeking to rent residential properties in Pennsylvania. The applicant seeks to provide necessary information to the landlord for rental property consideration, in accordance with Pennsylvania rental laws.
Please fill out the requested information completely and accurately.
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Applicant Information
- Full Name: ______________________________________
- Date of Birth: ____________________________________
- Social Security Number: __________________________
- Phone Number: ___________________________________
- Email Address: ___________________________________
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Current Address
- Street Address: __________________________________
- City: ___________________________________________
- State: Pennsylvania
- Zip Code: _______________________________________
- How long have you lived here? _____________________
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Previous Addresses
- Address 1: ______________________________________
- City: ___________________________________________
- State: __________________________________________
- Zip Code: _______________________________________
- How long did you live there? ______________________
- Address 2: ______________________________________
- City: ___________________________________________
- State: __________________________________________
- Zip Code: _______________________________________
- How long did you live there? ______________________
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Employment Information
- Current Employer: _________________________________
- Position: ________________________________________
- Salary: __________________________________________
- Employer Address: _________________________________
- Phone Number: ___________________________________
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References
- Reference 1 Name: ________________________________
- Relationship: _____________________________________
- Phone Number: ___________________________________
- Reference 2 Name: ________________________________
- Relationship: _____________________________________
- Phone Number: ___________________________________
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Additional Information
- Have you ever been evicted? Yes / No
- If yes, please explain: ____________________________
- Pet Information (Type and Breed): _________________
By signing below, I affirm that all the information provided is accurate to the best of my knowledge.
Signature: ___________________________________________
Date: ________________________________________________