The RCPSA is an Equal Opportunity Provider and Employer.
Landlord Authorization Form
______________
Date
RE: ______________________________________________________________________
Full Tenant(s) Name
______________________________________________________________________
Rental Property Address
The above tenant(s) have entered into a lease and is authorized to obtain service at this address as
a tenant of _________________________________.
Property Owner Name
___________________________________________________________________________
Property Owner Address
________________________________________ ______________________________________
Property Owner Contact Number(s) Property Owner Email Address
Signed:
_____________________________
Property Owner/Property Manager