RENTAL HOUSING AND TENANT REPORT FORM
Please highlight and copy this form on to your computer so you may print it out and submit to the Borough.
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BOROUGH OF
STROUDSBURG
Phone
(570) 421-5444, Fax (570) 421-2690
Property
Information
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Property
Location: |
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Apartment
Number: |
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Property Owner Information
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Name: |
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Mailing
Address: |
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Phone
Number: |
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Tenant Information
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Date
Tenant Moved In: |
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Number
of Adult Tenants: |
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Number
of Minor Tenants: |
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Names
(Adult
Tenants Only) |
Place of Employment
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Name
of Previous Tenant: |
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Date
Tenant Moved Out: |
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_______________________________________ ____________________________
Signature
of Property Owner
Date
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