Consumer Notice for Tenants
This is not a Contract

Licensee:            hereby states that with respect to all Triple Crown Corporation managed properties

I am acting in the following capacity:

A direct employee and agent of the Owner/Landlord pursuant to a property management or exclusive leasing agreement. You are not being represented unless you have your own agent.

I acknowledge that I have received this Notice:

RENTAL APPLICATION

1. Applicant Information

2. EMPLOYMENT Information

4. VEHICLE INFORMATION

Vehicle #1

Vehicle #2

5. OTHER OCCUPANTS

- Other occupants under the age of 18.
NAME
RELATIONSHIP
SOCIAL SECURITY NUMBER
DATE OF BIRTH
NAME
RELATIONSHIP
SOCIAL SECURITY NUMBER
DATE OF BIRTH
NAME
RELATIONSHIP
SOCIAL SECURITY NUMBER
DATE OF BIRTH
NAME
RELATIONSHIP
SOCIAL SECURITY NUMBER
DATE OF BIRTH
NAME
RELATIONSHIP
SOCIAL SECURITY NUMBER
DATE OF BIRTH

6. pets

7. OTHER INFORMATION

8.CONDITIONS OF PROPERTY

- The Property will be leased in the same condition as it is shown unless otherwise agreed to in writing.

9. SPECIAL PROVISIONS

- You hereby agree to pay the reservation fee of $200 as earnest money to be refunded to you if this application is not accepted unless you falsify information. Upon acceptance of this application, this deposit shall be retained & applied to 1st month's rent. After being notified of your acceptance, you will enter into a lease agreement. If you choose not to enter into a lease agreement the reservation fee will be forfeited as liquid damages in payment for time and effort in processing the application, marketing and rental expenses related to re-renting the reserved property. Regardless of circumstances if you do not enter into a lease agreement after acceptance of the application the deposit will be forfeited and is non refundable.

10. RENTER'S INSURANCE NOTICE

- You are hereby notified that while the landlord carries fire and casualty insurance on the property, it covers only the premises and not your possessions. The Landlord's insurance does not cover your personal liability. You must obtain renter's insurance covering the rental unit and personal property with no less than $300,000 in General/Personal Liability Coverage and $10,000 in Personal Contents Coverage through the term of the Lease and any subsequent renewals. A copy of the insurance certificate shall be delivered to Landlord, and shall name the Landlord as Interested Party/Additional Interest. If insurance coverage would be terminated for any reason during the Lease Term, or subsequent renewals, Tenant agrees to pay an additional $15.00 per month to the Landlord in connection with Landlord adding Tenant as an "additional insured" to an insurance policy maintained by the Owner/Landlord. Tenant agrees to provide any information and other cooperation needed for claims to be made under any insurance policy. Tenant understands that: (i) the liability coverage provided by this insurance policy may be less extensive than a personal liability insurance policy, or the liability coverage afforded to the "tenant" by a renter's insurance policy; and (ii) this insurance policy does not include any property insurance for Tenant's personal property. As a condition of the lease you will be required to have proof of renter's insurance at the lease signing.

11. AUTHORIZATION TO VERIFY INFORMATION

- Applicants acknowledge that the information provided on the rental application is true and correct and hereby authorize Triple Crown Corporation, (Landlord or Broker) to obtain a consumer report (credit report), Court Evictions Search, Criminal Background Report, Sex Offender Search, and Terrorism Search to verify the information contained here, and to report any information obtained to the Landlord. Applicants also authorize Triple Crown Corporation to re obtain any of this information at any time during or after their residency in order to pursue collection of any monies owed to Triple Crown Corporation. Applicants’ social security numbers are provided for this purpose. Applicants acknowledge that if they present false information the Landlord may reject this application. Applicants understand that giving false or incomplete information may result in forfeiture of any payments made in connection with this Rental Application. The verification of information provided by applicants is Triple Crown Corporation’s best effort to deal with criminal activity within our communities. Assume responsibility for your own safety. Triple Crown Corporation cannot guarantee or promise personal safety.

12. RETURNED CHECK POLICY

- Any payments made to Triple Crown Corporation during the application process that are returned for whatever reason will be subject to a $50 NSF fee along with a $20 Certified Mail fee to cover the costs incurred by Triple Crown Corporation. Failure to pay within 10 days will result in legal action being taken. No one will be allowed to move in with charges being owed due to an NSF payment.

13. THIRD PARTY VERIFICATION

- I hereby authorize all third parties indicated on my application to furnish the information requested below to Triple Crown Corporation and its partnerships. I release the third parties, their officers, agents and employees from any and all liability, which may result by breach of compliance with the verification request.

5351 Jaycee Avenue Harrisburg, PA 17112