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Applicant Information
Residential Lease Application
Each adult, 18 years and older, must complete a separate application. Incomplete
applications cannot be processed. A $25.00 non-refundable application fee (money order
or certified bank/ cashier’s check) must be submitted with each application. Along with the
completed application, a deposit of 1 month’s rent MAY be made to place the apartment
on hold for you while these materials are being reviewed. Should you decide NOT to move
forward prior to lease signing, this deposit is non-refundable to help offset the financial
loss of stopping future showings. You are not required to put down the deposit, but
showings will continue and applications will be accepted until a deposit is received on the
apartment you desire. Deposit will be credited toward funds due at lease signing. Deposits
are only returned if the application is NOT approved.
Name: Last
First
Middle
Date of Birth
Social Security #
Driver's License #
Other names you have used in the past
Home Phone
Cell Phone
Email
All other proposed occupants
Date of Birth
Relationship to Applicant
2)
3)
4)
Apartment Desired
1 Bedroom, 1 Bath
1 Bedroom, 1 Den, 2 Bath
2 Bedroom, 2 Bath
204
206
207
201
202
203
205
304
306
307
301
302
303
305
Parking Spaces Desired Length of Lease (2 year minimum) Rent per Month
None 1 space 2 spaces 3 spaces 2 years 3 years 4 years 5 years
$_________________
Current Residence
Street Address
City
State
Zip
Residency From
Residency To
Reason for Leaving
Did you give notice?
Were you asked to move? / Why?
Do you: Rent / Own?
Cost per month
Owner/Manager Name
Phone Number
Current Billing Name(s) for Utilities?
Previous Residence
Street Address
City
State
Zip
Residency From
Residency To
Reason for Leaving
Did you give notice?
Were you asked to move? / Why?
Rent / Own?
Cost per month
Owner/Manager Name
Phone Number
Billing Name(s) for Utilities?
Prior Residence
Street Address
City
State
Zip
Residency From
Residency To
Reason for Leaving
Did you give notice?
Were you asked to move? / Why?
Rent / Own?
Cost per month
Owner/Manager Name
Phone Number
Billing Name(s) for Utilities?
601 North 2nd. Street, Philadelphia, PA 19123
PLEASE PRINT Form: 15075
4
15099
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