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Form #1591APPLICATION RECEIPT
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This receipt is a type of acknowledgement issued to applicant as a proof of his submission of rental application. It provides the details and the purpose of charges collected from the applicant.
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APPLICATION RECEIPT
Name of
the Applicant: _________________________________________________________
first middle last
Address:
______________Unit #____________City______________ State____________
Applied
for the Building Address:
___________________ Unit#:________
Rent Amount:
$______per_____ Security deposit: _________________
Lease Term:
______________
RECEIVED from
applicant named above, the sum of $_______________________ in the form of
(cash, check, other):__________________, which shall
be utilized to screen Applicant with respect to credit history and other
information of the Applicant. The amount charged is as follows:
1. Cost to verify and process screening information
$______
2. Cost of credit report, eviction search and or other
screening reports $______
3. Total fee charged $____ ( which cannot exceed $___ per
applicant, which will be revised annually)
The amount
received is non-refundable.
______________________
(Receiving
Agency)
______________________
(Seal)
______________________
Date
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Keywords: APPLICATION ,RECEIPT, RENTAL
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