Complete Your Custom ORHA Rental Form

Please Fill In the Form

Remember My Form Information

Form42 : APPLICANT SCREENING CHARGE RECEIPT

Required entries are indicated by blue icons or *

Applicant Name(s)* (required)

Property Address* (required)

Unit #

Applicant Mailing Address

City

State

Zip Code

Amount of Charge:

0.00

"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. The purpose of this payment is to process an Application for a Rental 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:

Owner/Agent

Address

City

State

Zip

Telephone

Form42 : APPLICANT SCREENING CHARGE RECEIPT

Rev.7/21

Click "Preview Form" below to check your information.
If the form is correct, close the preview to return to this page, then click "Generate PDF". Your form will be created and added to your cart.
From your cart, you can return to the Forms Store to create more forms, delete forms from your cart or purchase the items in your cart.

Preview Form