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Get PA PA-1000 RC 2004

You must submit proof for each address. RENT CERTIFICATE Your landlord must provide all the information on Lines 1 through 8. Your landlord, or your landlord s authorized agent, must sign this Rent Certificate. If your landlord, or your landlord s authorized agent, does not sign this Rent Certificate, you must complete Lines 1 through 8 and the Rental Occupancy Affidavit below. Your Rental Occupancy Affidavit must be notarized. 1. Street address of the residence for which the claimant paid.

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