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Online Rental Application

Rental Information

Address of apartment you are applying for *

Apartment # *

Rent Amount * $

Move-in date requested *

Month

Day

Year

Number of persons in household *

Primary Applicant Information

First Name *

Middle Name *

Last Name *

Date of Birth *

Social Security Number:
Call to provide

Contact Phone *

Applicant Email *

Have you moved more than 2 times in the last five years? *

No

Yes

Were you ever evicted? *

No

Yes

Were you ever convicted of a felony? *

No

Yes

Current Address

Street Address *

City *

State *

Zip *

Monthly Payment * $

Years at address *

Reason for moving *

Landlord name *

Landlord Phone *

Previous Address 1

Street Address *

City *

State *

Zip *

Monthly Payment * $

Years at address *

Reason for moving *

Landlord name *

Landlord Phone *

Previous Address 2

Street Address

City

State

Zip

Monthly Payment $

Years at address

Reason for moving

Landlord name

Landlord Phone

Relative not living with you (To be contacted in case of an emergency)

Name *

Phone Number *

Employment Information

Occupation / Job Title *

Employer Name *

Date started *

Month

Day

Year

Employer Street Address *

Employer City *

Employer State *

Employer Zip *

Employer Phone *

Employer Fax *

Supervisor *

Gross weekly income *

Previous Employer *

Previous Employer Phone *

Automobile Information

Drivers License # *

Make / Model of Vehicle *

License Plate # *

State Issued *

Pet Information

Pet type / description

Pet height

Pet age

Personal References

Name *

Address *

Phone Number *

Relationship to applicant *

Co-Applicant Information (spouse, roommate, co-signer, etc.)

First Name

Middle Initial

Last Name

Date of Birth

Social Security Number:
Call to provide

Contact Phone

Applicant Email

Have you moved more than 2 times in the last five years?

No

Yes

Were you ever evicted?

No

Yes

Were you ever convicted of a felony?

No

Yes

Current Address

Street Address

City

State

Zip

Monthly Payment $

Years at address

Reason for moving

Landlord name

Landlord Phone

Previous Address 1

Street Address

City

State

Zip

Monthly Payment $

Years at address

Reason for moving

Landlord name

Landlord Phone

Previous Address 2

Street Address

City

State

Zip

Monthly Payment $

Years at address

Reason for moving

Landlord name

Landlord Phone

Relative not living with you (To be contacted in case of an emergency)

Name

Phone Number

Employment Information

Occupation / Job Title

Employer Name

Date started

Month

Day

Year

Employer Street Address

Employer City

Employer State

Employer Zip

Employer Phone

Employer Fax

Supervisor

Gross weekly income

Previous Employer

Previous Employer Phone

Automobile Information

Drivers License #

Make / Model of Vehicle

License Plate #

State Issued

Pet Information

Pet type / description

Pet height

Pet age

Personal References

Name

Address

Phone Number

Relationship to applicant

Additional Occupants

Please list name (first, middle & last), and age of others who will live in the apartment:

Additional Occupant 1

Name

Age

Additional Occupant 2

Name

Age

Additional Occupant 3

Name

Age

Additional Occupant 4

Name

Age

Application Agreement

Tenant Selection Policy

Income - The annual apartment rental must not exceed 1/3rd of applicant(s) gross annual income. Income must be verifiable.
Landlord References - If a present or previous landlord gives an applicant(s) a poor reference, the application will likely be denied.
Credit Check - Applicant must have good credit.
Criminal - Any applicant(s) that has been convicted of a felony will be denied.
College Students - Full time students under the age of 23 must have a parent or guardian with good credit and verifiable income co-sign their lease.

In order for us to process your application and perform the credit check, there is a nonrefundable $35.00 application fee. False Statements by applicants are grounds for immediate rejection.

DIGITAL SIGNATURE *

I/We have applied for an apartment. In applying for the apartment, I/We have completed an application containing various information. I/We hereby give my/our consent for information contained in the apartment application and in other documents required in connection with part of its quality control programs, to be verified or re-verified. Penn Real Estate Co., its agents, and successors and assignees may make this verification either directly or through a credit-reporting agency. Such information includes, but is not limited to, employment history, income, and licensing bank, money market and similar account balances, deposits and credit history.

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Apartments In Williamsport PA

Penn Real Estate | PO Box 665, Williamsport , PA 17703 | 570-322-4664 | pennrealestate@epix.net

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