Rental Property Tenant Notification Form
ADVERTISEMENT
1BOROUGH OF EDDYSTONE
RESIDENTIAL RENTAL PROPERTY TENANT NOTIFICATION FORM
(FOR CONTINUED CERTIFICATE OF OCCUPANCY)
th
Borough of Eddystone, 1300 E 12
Street, Eddystone, PA 19022
____________________________________________________________________________________________________________
Owner(s) or designated managers of Residential Rental properties shall complete, submit, and obtain approval of this
form, prior to the occupancy of any new or additional tenants.
****************************************************************************************************************
Owner or Designated Manager Name: ___________________________________________________
(
Information shall agree with the Residential Rental Operating License)
Phone #
________________________ Phone #
(Day)
(Nights/Weekends)________________________________
Eddystone Property Address: _________________________________________________________
st
Apartment/Unit #________ Location within Dwelling
(Example – 1
floor, Rear) _______________________
Rental Unit Description: Total square feet ____________ Total number of rooms: _____________
Number of kitchens__________ Number of baths: __________________
Number of bedrooms_________ Yard (
):
Y/N
Yes______ No_______
***************************************************************************************************************
Accountable Tenant Information – First and Last name: ______________________________________
Total number of individuals / family members occupying premises/unit: __________________________________
Additional Tenants, provide names, ages under eighteen (18), and relationship- (Example = John Smith, 16, son)
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
___________________________________________________________________________________
__
Does Tenant receive HUD Section 8 Housing Assistance payments (Voucher)? Yes____ No____
If Yes – Provide a copy of the Voucher
***************************************************************************************************************
Signature and Notary
The above name Owner/Manager does hereby attest that the property is used as and represented for
residential rental and all above information is accurate and correct.
Print Name :_________________________________)
Sworn to and subscribe before me this
_______day of ____________, _________
__________________________
__________________________________
Signature of Owner / Manager
Notary Public
The above named Accountable Tenant does hereby attest that the above tenet information is correct.
Print Name :_________________________________)
Sworn to and subscribed before me this
______day of ____________, __________
___________________________
__________________________________
Signature of Accountable Tenant
Notary Public
***************************************************************************************************************
Appropriate Agent Approval (official use only)
Borough Agent Name______________________________ Approval Date_________________
___________________________________________________________________________________________________________
Phone: 610-874-1100, Fax: 610-874-1605
Tenet Notification Form – 02/03/06 Rev 0
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal