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Burnham, Reedsville, Lewistown & Huntingdon, PA Phone 717-250-5020 or 814-386-2799

Date ____________________________

RENTAL APPLICATION
Primary Applicant Name___________________________________________________________________________

Home phone __________________________________________ Cell Phone ________________________________

Current Address __________________________________________________________________________________

How long at this address? _________________________________

Currently Monthly Rent? _________________________________

Landlord’s Name _________________________________________ Phone ________________________________

Are you currently employed? _______________________________

Current Employer _________________________________________ Phone ________________________________

How long at this job? ____________________

Current Net Monthly Income (take home pay) _______________________________________________________

Other Income ____________________________________________

Secondary Applicant Name_________________________________________________________________________

Home phone ____________________________________________Cell Phone _______________________________

Current Address _________________________________________

How long at this address? _________________________________

Currently Monthly Rent? _________________________________

Landlord’s Name _________________________________________ Phone ________________________________

Are you currently employed? _______________________________

Current Employer _________________________________________ Phone ________________________________

How long at this job? _____________________________________

Current Net Monthly Income (take home pay) ____________________________

Other Income ____________________________________________

Total number of people that will be living in this apartment? ______________________________________________

Primary Applicant Signature ______________________________________________ Date ______________________

Secondary Applicant Signature ____________________________________________ Date ______________________

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