CH Application

College Hill Application

Consumer Notice For Tenants
THIS IS NOT A CONTRACT
(Licensee) Susquehanna Realty Management LLC hereby states that with respect to the property,we are acting in the following capacity:

___ Owner/Landlord of the Property;

___ A direct employee of the Owner/Landlord; OR

_X_ An agent of the Owner/Landlord pursuant to a property management or exclusive listing agreement.

College Hill Application

Each applicant will need to complete the form below. In order for your application to be processed you will need to pay the application fee. Your application fee may be submited online through PayPal or you mail mair a check or money order to our office. Applications will be considered received when the application fee is paid and will be processed in order accordingly.

Please indicate the unit number & bedroom you are applying for.
Full Name:
Is the applicant at least 18 years old?
Social Security Number:
Driver's License/Photo ID No. & State Issued:
Home Phone:
Cell Phone:
Email Address:
Home Address
Street Address:
City:
State:
Zip Code:
Emergency Contact
Name:
Relationship:
Phone Number:
Vehicle Information
Make/Model:
Year:
Color:
License Number & State:
Vehicle Identification Number:
Roommates: Please list the names of the people you wish to reside with.
Roommate 1:
Roommate 2:
Roommate 3:
Special Provisions: Please list any special provisions you may need in your apartment unit.
Authorization: Applicant authorizes Landlord or Broker to obtain any information deemed necessary to evaluate this Application. This information may include, but is not limited to, credit reports, criminal history, judgements of record, rental history, verification of employment and salary, employment history, vehicle records, and licensing records. Broker may report to Landlord any information obtained by Broker for evaluation of the Application. Applicant acknowledges that all information in the Application is true and correct. Applicants acknowledge that if they present false or incomplete information Landlord may reject this Application. Applicants understand that giving false or incomplete information may result in the forfeiture of any payments made in connection with this Rental Application.
Please indicate how you will submit your application fee: