Newport Borough Landlord Form

NEWPORT BOROUGH LANDLORD REPORT FORM (SUBMISSION REQUIRED)

NOTE: Please use a separate form for each rental unit. This form may be copied or you can pick up copies at the Newport Municipal Building, 231 Market Street, Newport, PA 17074.

LANDLORD INFORMATION

Name of Landlord:(Required)

First Last

Address of Landlord:(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Telephone #:(Required)

Email Address:

NEW OR CURRENT TENANT INFORMATION (To Be Filed Within Ten Days of Arrival)

New or Current Tenant - Check below if,

Same as previous year.

Address of Rental Unit:(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name(s) of New Adult Occupant(s):(Required)

Number of children under 18:

Mailing Address (if different than physical address):(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Telephone #:(Required)

Email Address:

Date of Occupancy:(Required)

The borough office must be updated within 10 days of any changes in tenant status. Annual reporting will occur in January of each year.

LANDLORD SIGNATURE/DATE REQUIRED

Signature of Landlord (Typed signature is acceptable for electronic submission):(Required)

Date(Required)

***This form may be filed by mail, fax, email, or online submittal.

Website: https://www.newportboro.com/information/formandapplications/landlord-form/
Fax: (717)567-3754
Email: [email protected]

Mail To:
Attn: Borough Secretary
Newport Borough
231 Market Street
Newport, PA 17074

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