ࡱ> sur'` 9bjbj{P{P .`:: ||||L#L#L#8#t#4$((((,,\-03333333$5h84QG/O+,G/G/4||((h4m1m1m1G/X|R((3m1G/3m1m1"m1($ S]L#/Xm1m1~404m18/8m18m13-L-6m1-,-f3-3-3-441X3-3-3-4G/G/G/G/d||||||h4 Borough of Penbrook Status of Occupancy Report Borough Code 113 mandates that landlords report all tenants living in the Borough within 30 days of any change in tenants and before the 10th of January of every year Owner(s) Name  FORMTEXT       Owner s Address  FORMTEXT        (STREET, CITY, STATE AND ZIP CODE) Owner s Phone Number: Home:  FORMTEXT       Cell:  FORMTEXT        Rental Property Address:  FORMTEXT       (One property per form, only. Hyphenated addresses are not allowed) Number of Units:  FORMTEXT    Date of Report:  FORMTEXT        PROVIDE THE FOLLOWING DATA FOR EACH RESIDENT (PLEASE PRINT LEGIBLY) Resident Name (PRINT)Adult (18 or Over)Child (Under 18)Telephone NumberUnitE.G. John Doe FORMCHECKBOX  FORMCHECKBOX 717-555-1212Apt 1 FORMTEXT       FORMCHECKBOX  FORMCHECKBOX  FORMTEXT       FORMTEXT       FORMTEXT       FORMCHECKBOX  FORMCHECKBOX  FORMTEXT       FORMTEXT       FORMTEXT       FORMCHECKBOX  FORMCHECKBOX  FORMTEXT       FORMTEXT       FORMTEXT       FORMCHECKBOX  FORMCHECKBOX  FORMTEXT       FORMT^v z  4 6 D F H J " 6 8 F X Z n p ~ ȽȽ׎ȽqȽ_#jCJOJQJU^JaJ#jCJOJQJU^JaJCJOJQJ^JaJCJ OJQJ^JaJ #jCJOJQJU^JaJ#jCJOJQJU^JaJCJOJQJ^JaJjCJOJQJU^JaJ jOJQJU^JmHnHuH*OJQJ^J OJQJ^J5OJQJ^J%(^` F J V Z   $ a$ $  d 4  $ a$999 8  . 0 D F T V X Z *,.|t||l|Z#jCJOJQJU^JaJjUjU jU jOJQJU^JmHnHu#jCJOJQJU^JaJ#jCJOJQJU^JaJCJOJQJ^JaJ>*CJOJQJ^JaJ OJQJ^JjCJOJQJU^JaJ#jCJOJQJU^JaJCJOJQJ^JaJ# 6Xz$ $Ifa$ $IfK>..>$ $Ifa$ $Ifkdp$$Iflr0pP!D%@ $ p t0(644 la<`<33 $$Ifa$kd$$IflCr0pP!D%@ $ p t0(644 la $If.8:<>Z\^`b~ƿƿƿƿёܿnѿ\nƿ#jCJOJQJU^JaJ jCJU^JaJmHnHu#jCJOJQJU^JaJ#jCJOJQJU^JaJjOJQJU^Jj,OJQJU^J OJQJ^JjOJQJU^JCJOJQJ^JaJjCJOJQJU^JaJ(jCJOJQJU^JaJmHnHu#"8/ $$Ifa$kd$$Iflr0pP!D%@ $ p t0(644 lap $If "$@BDFH\^lnp··‚··p[(jCJOJQJU^JaJmHnHu#j CJOJQJU^JaJ jCJU^JaJmHnHu#j CJOJQJU^JaJ#j CJOJQJU^JaJCJOJQJ^JaJjCJOJQJU^JaJj OJQJU^J OJQJ^JjOJQJU^Jj) OJQJU^J"Fn/kd $$Iflr0pP!D%@ $ p t0(644 lap $If $$Ifa$  .02FHJTVXZ\prt~··‚··p[(jCJOJQJU^JaJmHnHu#jCJOJQJU^JaJ jCJU^JaJmHnHu#jx CJOJQJU^JaJ#j CJOJQJU^JaJCJOJQJ^JaJjCJOJQJU^JaJj OJQJU^J OJQJ^JjOJQJU^Jj OJQJU^J0XZ/kd $$Iflr0pP!D%@ $ p t0(644 lap $If $$Ifa$Z0 $$Ifa$ $If00 0 000000204060@0B0D0F0b0·”··”··nY(jCJOJQJU^JaJmHnHu#jCJOJQJU^JaJ#juCJOJQJU^JaJU jCJU^JaJmHnHu#jCJOJQJU^JaJCJOJQJ^JaJjCJOJQJU^JaJjOJQJU^J OJQJ^JjOJQJU^JjOJQJU^J"EXT       FORMTEXT       FORMCHECKBOX  FORMCHECKBOX  FORMTEXT       FORMTEXT       FORMTEXT       FORMCHECKBOX  FORMCHECKBOX  FORMTEXT       FORMTEXT       FORMTEXT       FORMCHECKBOX  FORMCHECKBOX  FORMTEXT       FORMTEXT       FORMTEXT       FORMCHECKBOX  FORMCHECKBOX  FORMTEXT       FORMTEXT       FORMTEXT       FORMCHECKBOX  FORMCHECKBOX  FORMTEXT       FORMTEXT       FORMTEXT       FORMCHECKBOX  FORMCHECKBOX  FORMTEXT       FORMTEXT       FORMTEXT       FORMCHECKBOX  FORMCHECKBOX  FORMTEXT       FORMTEXT       Telephone Numbers are required for all adult tenants *Report the names of all residents whether they are on the lease or not. Certification: The undersigned hereby certifies that the above information is true, accurate and complete. Signature: ____________________________ Date: ____/____/______ Owner Signature: ____________________________ Date: ____/____/______ Owner Mail to: Borough Manager, Penbrook Borough, 150 S. 28th Street, Penbrook, PA 17103     00D0h000E8//8 $$Ifa$ $Ifkd$$Iflr0pP!D%@ $ p t0(644 lap b0d0f0h0j0000000000000000000000001111$1·”··”··p[(jCJOJQJU^JaJmHnHu#jCJOJQJU^JaJ#jfCJOJQJU^JaJ jCJU^JaJmHnHu#jCJOJQJU^JaJCJOJQJ^JaJjCJOJQJU^JaJj|OJQJU^J OJQJ^JjOJQJU^JjOJQJU^J 0001*1N18// $$Ifa$kd$$Iflr0pP!D%@ $ p t0(644 lap $If$1&1(1*1,1H1J1L1N1P1d1f1h1r1t1v1x11111111111111111·”··”··p[(jCJOJQJU^JaJmHnHu#jCJOJQJU^JaJ#jWCJOJQJU^JaJ jCJU^JaJmHnHu#jCJOJQJU^JaJCJOJQJ^JaJjCJOJQJU^JaJjmOJQJU^J OJQJ^JjOJQJU^JjOJQJU^J N1v111118/ $$Ifa$kd$$Iflr0pP!D%@ $ p t0(644 lap $If11111 2 2222&2(2*2426282:2N2P2R2\2^2`2b2d2x2z2|222222·”··”··p[(jCJOJQJU^JaJmHnHu#jqCJOJQJU^JaJ#jHCJOJQJU^JaJ jCJU^JaJmHnHu#jCJOJQJU^JaJCJOJQJ^JaJjCJOJQJU^JaJj^OJQJU^J OJQJ^JjOJQJU^JjOJQJU^J 1282`2b22/kd$$Iflr0pP!D%@ $ p t0(644 lap $If $$Ifa$222222222222222223333 3"3$3&3:3<3>3H3J3L3N3j3·”··”··p[(jCJOJQJU^JaJmHnHu#jbCJOJQJU^JaJ#j9CJOJQJU^JaJ jCJU^JaJmHnHu#jCJOJQJU^JaJCJOJQJ^JaJjCJOJQJU^JaJjOOJQJU^J OJQJ^JjOJQJU^JjOJQJU^J 2222"3$3/kd$$Iflr0pP!D%@ $ p t0(644 lap $If $$Ifa$$3L3p3333 $$Ifa$ $Ifj3l3n3p3r333333333333333333333334 4 444,4·”··”··p[(jCJOJQJU^JaJmHnHu#jS CJOJQJU^JaJ#j*CJOJQJU^JaJ jCJU^JaJmHnHu#jCJOJQJU^JaJCJOJQJ^JaJjCJOJQJU^JaJj@OJQJU^J OJQJ^JjOJQJU^JjOJQJU^J 33424V4~4E8//8 $$Ifa$ $Ifkd$$Iflr0pP!D%@ $ p t0(644 lap ,4.4042444P4R4T4V4X4l4n4p4z4|4~444444444444444444·”··”··p[(jCJOJQJU^JaJmHnHu#jD#CJOJQJU^JaJ#j"CJOJQJU^JaJ jCJU^JaJmHnHu#j!CJOJQJU^JaJCJOJQJ^JaJjCJOJQJU^JaJj1!OJQJU^J OJQJ^JjOJQJU^Jj OJQJU^J ~4444458// $$Ifa$kd"$$Iflr0pP!D%@ $ p t0(644 lap $If4444455555.50525<5>5@5B5V5X5Z5d5f5h5j5l55l667:88.9B99·”··”·~shh\>*CJOJQJ^JaJCJOJQJ^JaJCJOJQJ^JaJ5>*#j %CJOJQJU^JaJ jCJU^JaJmHnHu#j$CJOJQJU^JaJCJOJQJ^JaJjCJOJQJU^JaJj"$OJQJU^J OJQJ^JjOJQJU^Jj#OJQJU^J!5@5h5j5l558// kd%$$Iflr0pP!D%@ $ p t0(644 lap $If55j6l6D7F776888:88*9,9.9999999999999$a$ $ a$  9999999999999 jUCJOJQJ^JaJ>*CJOJQJ^JaJ>*CJH*OJQJ^JaJ 999$a$,1h/ =!"#$% DText30 UPPERCASEDText20 UPPERCASEvDText35vDText32DText33 UPPERCASEvDText38vDText37$$If!vh5@ 5$ 55p5#v@ #v$ #v#vp#v:Vl t(65@ 5$ 55p5atDeCheck2tDeCheck3$$If!vh5@ 5$ 55p5#v@ #v$ #v#vp#v:VlC t(65@ 5$ 55p5/ avDText17tDeCheck2tDeCheck3vDText18vDText28$$If!vh5@ 5$ 55p5#v@ #v$ #v#vp#v:Vl t(65@ 5$ 55p5ap vDText17tDeCheck2tDeCheck3vDText18vDText28$$If!vh5@ 5$ 55p5#v@ #v$ #v#vp#v:Vl t(65@ 5$ 55p5ap jDtDeCheck2tDeCheck3vDText18vDText28$$If!vh5@ 5$ 55p5#v@ #v$ #v#vp#v:Vl t(65@ 5$ 55p5ap vDText29tDeCheck2tDeCheck3vDText18vDText28$$If!vh5@ 5$ 55p5#v@ #v$ #v#vp#v:Vl t(65@ 5$ 55p5ap jDtDeCheck2tDeCheck3vDText18vDText28$$If!vh5@ 5$ 55p5#v@ #v$ #v#vp#v:Vl t(65@ 5$ 55p5ap jDtDeCheck2tDeCheck3vDText18vDText28$$If!vh5@ 5$ 55p5#v@ #v$ #v#vp#v:Vl t(65@ 5$ 55p5ap jDtDeCheck2tDeCheck3vDText18vDText28$$If!vh5@ 5$ 55p5#v@ #v$ #v#vp#v:Vl t(65@ 5$ 55p5ap jDtDeCheck2tDeCheck3vDText18vDText28$$If!vh5@ 5$ 55p5#v@ #v$ #v#vp#v:Vl t(65@ 5$ 55p5ap jDtDeCheck2tDeCheck3vDText18vDText28$$If!vh5@ 5$ 55p5#v@ #v$ #v#vp#v:Vl t(65@ 5$ 55p5ap jDtDeCheck2tDeCheck3vDText18vDText28$$If!vh5@ 5$ 55p5#v@ #v$ #v#vp#v:Vl t(65@ 5$ 55p5ap jDtDeCheck2tDeCheck3vDText18vDText28$$If!vh5@ 5$ 55p5#v@ #v$ #v#vp#v:Vl t(65@ 5$ 55p5ap @@@ NormalCJ_HaJmH sH tH DA@D Default Paragraph FontRi@R  Table Normal4 l4a (k@(No Listj@j  Table Grid7:V04@4 Header  !4 @4 Footer  !  `/0#%st`a,=BCRdv#7KL`r "4FZno01EWi}+?SThz56   b 0@0@00000000@000000000@0@00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 000000000000@0000@000@000@000@00000p000T/0#%st`a,=BCRdv#7KL`r "4FZno01EWi}+?SThz56   b 0000@000@0@0@0@000000000@0@0@0 @0 @0 @0 00> @0 @0 @0 @0 @0 00: @0 @0 @0 @0 @0 0$06 @0 @0 @0 @0 @0 0*02 @0 @0 @0 @0 @0 000. @0 @0 @0 @0 @0 060* @0 @0 @0 @0 @0 0<0& @0 @0 @0 @0 @0 0B0" @0 @0 @0 @0 @0 0H0 @0 @0 @0 @0 @0 0N0 @0 @0 @0 @0 @0 0T0 @0 @0 @0 @0 @0 0Z0 @0 @0 @0 @0 @0 0`0 @0 @0@0@00000000000h0000  .b0$112j3,4499  "$')+. 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