Rental Application

801 N. Bambrey Street

Philadelphia, PA 19130

P&L Homes, LLC

1212 Lafayette Road

Gladwyne, PA 19035

215-990-4850

Application Date______

Move in date: July 1, 2015 End date: July 1, 2016 (renewable)

Monthly rent: $1700 + utilities

Personal Information:

Full name______Marital status______

Number of children ______Spouse name______

Social Security Number ______Date of birth______

Telephone numbers (h)______(cell)______

Email address______

Present address______

City______

State______Zip code______

Length of time at current address______

Monthly rent______

Present landlord ______Phone number______

Reason for leaving______

In case of emergency notify______Phone______

Vehicle make/year______Tag number______

Operator's driver's number______State issued______

Rental app page 2—801 N. Bambrey Street

Present employer______How long______

Address______Phone______

Occupation______Salary______

Supervisor______Phone______

Previous employer______Phone______

Student at______Year______

Checking account at______

Savings account at ______

Credit cards

Company______Account #______

Company______Account #______

Personal reference______Phone______

Applicant certifies that and represents that all information on this application is correct,

that they are not breaking their lease, that they have paid their rent/mortgage payment in

a timely fashion for the past twelve months, that they have received no notices of lease

termination or eviction, and that they have not filed for bankruptcy within the last five

years, and are presently financially solvent.

Applicant agrees to pay security deposit, equal to one months rent, first months rent and last months rent.

AUTHORIZATION TO OBTAIN INFORMATION

Applicant hereby authorizes lessor to verify accuracy of all statements in this application,

and also authorize all employers, previous landlords, mortgage holders, all banks and any other credit on this lease application, to release all information concerning me or my

accounts, my rental history or payments, my employment history, including the likelihood

of future employment, for the purpose of verifying this application, and determining my

ability to afford the contractual obligations of this lease.

Signature______

Print Name______

Date______

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Fax by calling below # first

Questions: 215-990-4850