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Form #42 : APPLICANT SCREENING CHARGE RECEIPT

 

Required entries are indicated by blue icons or *

 
 
 
 
 
 

"Applicant Screening Charge" means any nonrefundable payment of money charged by an Owner/Agent of a prospective Tenant prior to entering into a rental agreement with that applicant for a residential dwelling unit, the purpose of which payment is to process an application for a residential dwelling unit.

I acknowledge the receipt of an applicant screening charge.
 

Please Note: Signature field must be filled in and signed after printing.

Owner/Agent Signature:   Date:

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