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Rental Application
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  • We require each adult applicant to print, sign, date, and return the Employment Verification and Landlord Verification forms to us, the IRS W9 form, and the application below.

  • We require a copy of your current driver's license or other government issued photo ID (attach to this application)

  • We require proof of income via previous two months cancelled checks or pay stubs (attach to this application). For new jobs, please attach Job Letter/Employment Contract. Students must submit a Financial Aid Statement (if applicable). International students without a credit score receiving financial aid must submit a copy of their I-20 form.

  • We require a $35 non-refundable fee PAYABLE TO KENNETH CARROLL in order to process this application. (An additional application and $25 non-refundable fee is required for each additional prospective adult tenant).

  • If your current and previous employers charge for employment verification, you are responsible for providing such verification in writing from your employers, at your expense.

  • SIGN AND DATE HERE:__________________________________

Section 1 - Information Required For Credit Report:
This application is for a: Resident Co-signer
Apartment or house applied for:
Monthly Rent:
Applicants Name:
Applicants Birth date:
Driver's License Number:
Social Security #:
Current Address:
Current City:    
Current State
Current Zip
Previous Address:
Previous City:
Previous State:
Previous Zip:
Voice #:
Fax #:
Email Address:
Section 2 - Present Housing Information:
Present landlord or agent:
Present landlord/agent address:
Present landlord/agent phone #:
Previous landlord or agent:
Previous landlord/agent address:
Previous landlord/agent phone #:
Reason for moving from present address:
Present rent:
Rent paid to what date:
Section 3 - Employment Record and other Income Sources
Present employer:
Employer's Address:
Length of Employment:
Employer's Phone #:
Previous employer:
Previous Employer's Address:
Length of Employment:
Previous Employer's Phone #:
Previous Position:
Previous Salary:
Section 4 - References and third party names and addresses
Bank reference 1 (Bank & Acct #):
Bank reference 2 (Bank & Acct #):
Personal reference 1:
Personal reference 2:
Personal reference 3:
In case of emergency notify 1:
In case of emergency notify 2:
Section 5 - College and University Information (if applicable)
What school do you attend:  
Other Income (Including Financial Aid, parents, etc.):  
Rental Consumer Notice: This is not a contract
Kenneth Carroll hereby states that with respect to the rental properties
(235 S. 21st Street, 2101 Spruce Street, 1084 Hollow Road, and 210 Byers Road),
I am acting in the following capacity:

With respect to all other rental properties Kenneth Carroll Real Estate
is acting in the following capacity:

Applicants Credit Check Consent:

“I hereby authorize the managing agent for the owner of the property to obtain a consumer report, and other information it deems necessary, for the purpose of evaluating my application. I understand that such information may include, but is not limited to, credit history, civil and criminal information, records of arrest, rental history, employment/salary details, vehicle records, licensing records, and/or any other necessary information. I understand that subsequent consumer reports may be obtained and utilized under this authorization in connection with an update, renewal, extension or collection with respect to or in connection with the rental lease of a residence, for which this application was made. I hereby expressly release the owner of the property and it's agents, employees, representatives, affiliates, and any procurer or furnisher of information, from any liability what-so-ever in the use, procurement, or furnishing of such information, and understand that my application information may be provided to various local, state, and/or federal government agencies including without limitation, various law enforcement agencies."

I hereby deposit one month's rent as earnest money (via a check separate from that of the application fee) to be refunded or returned to me if this application is not accepted within five business banking days. Upon acceptance of this application, this deposit shall be retained as the security deposit. When so approved and accepted I agree to execute a lease for twelve months or longer (or shorter with the prior written approval of landlord) before possession is given. At the signing of the lease, I also agree to pay the first month's rent and last month's rent as required. If this application is not approved and accepted by the owner or the agent, the deposit will be refunded, and the applicant hereby waives any claim for damages for non-acceptance.

IMPORTANT: Please initial ALL items below
____ I understand that my application fee is non-refundable
____ I understand that if after making my application or being accepted I do not take occupancy of the property, I forfeit my security deposit.
____ I understand that the property will be rented as is.
____ I understand and agree possession of the property will not be prior to the agreed upon move-in date and without execution of my lease.
____ I understand the information presented to me on the property I'm applying for is deemed accurate and reliable but not guaranteed or warranted by the owner of the property, or it's agents, employees, representatives, or affiliates.

Has Applicant Listed Herein Ever: (if any of the answers below are “yes”, please explain)
a. Been convicted of and/or pled “guilty” or “no contest” to any felony offense?
b. Been evicted from a rental dwelling, or received a notice to vacate?
c. Have you ever broken a rental agreement?
d. Have you ever declared bankruptcy?

Return by facsimile transmission (FAX) of this application bearing the signature(s) of the applicant(s) shall constitute a duly executed release by the applicant, for the Agent to obtain all the above information and use it for the purposes for which the application is submitted. In addition, I agree to conduct real estate transactions electronically pursuant to the Pennsylvania Electronic Transactions Act.

I acknowledge Receiving The EPA Documents
"Protect Your Family From Lead in Your Home"
Required for housing built pre-1978
"A Brief Guide to Mold, Moisture, and Your Home,"
The State Required Consumer Notice
and For Philadelphia Tenants:
"Partners For Good Housing" Brochure
I acknowledge receiving a full copy of the sample lease and
understand that my specific terms and conditions will vary.

Applicant's signature ____________________________

complete and then scan this application and all required documents then email to kennycarroll@comcast.net
or mail it to 1565 Hollow Road - Suite 85 - Birchrunville PA 19421
For FedEX, UPS, DHL, or Airborne Express use 1565 Hollow Road, Chester Springs, PA 19425
We require the application fee(s) prior to processing the application(s)

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