Landlord/Tenant Report

If you need assistance with completing this online application please contact Sandra Brenneman, Secretary at 717-624-4544 or via email at sbrenneman@oxfordtwp.com.

In accordance with CHAPTER 11 SECTION 105, this form must be completed and filed with the Township Office when any change or upon the vacancy of any rental unit (residential or business). Reports must be filed within Ten (10) days of any changes in occupancy.

Date Application Submitted *

Date Received:

Applicant please skip this. Office staff will fill this in.

Rental Address *

Address Line 1

Address Line 2

City

State

Zip Code

Current Tenant(s) *

First

Last

Effective Date *

Previous Tenant(s) *

First

Last

Forwarding Address *

Address Line 1

Address Line 2

City

State

Zip Code

Owner's Name *

First

Last

Owner's Address *

Address Line 1

Address Line 2

City

State

Zip Code

Owner's Phone *

Owner's Signature *

PLEASE NOTE: A report MUST be filed on EACH rental unit. Thank you for your cooperation.