Rental Application

NAME OF APPLICANT*

PHONE (Indicate home, work or cell)*

Format: (000) 000-0000.

EMAIL*

example@example.com

INITIALS*

PRESENT ADDRESS*

DATES OF CURRENT OCCUPANCY

CITY STATE ZIP CODE*

AUTOMOBILE: MAKE/YEAR/COLOR

SOCIAL SECURITY #*

PRESENT LANDLORD*

COMPLETE ADDRESS*

PHONE NUMBER*

FORMER LANDLORD*

OCCUPANCY*

COMPLETE ADDRESS*

PHONE NUMBER

CURRENT EMPLOYER*

COMPLETE ADDRESS*

PHONE NUMBER*

Format: (000) 000-0000.

OCCUPATION/SOURCE OF INCOME*

TYPE OF BUSINESS & YEARLY SALARY*

LENGTH OF EMPLOYMENT

PERSONAL REFERENCE*

COMPLETE ADDRESS*

PHONE NUMBER*

Format: (000) 000-0000.

IN CASE OF EMERGENCY NOTIFY (NAME) COMPLETE ADDRESS

NAME OF ALL CO-TENANTS (EACH ADULT MUST FILE A SEPARATE APPLICATION)*

TOTAL NO. OF OCCUPANTS*

NO. OF ADULTS*

NO. OF PETS*

NAMES & AGES OF MINOR CHILDREN*

Base rent per month (Subject to escalation as set forth in lease) Other Monthly Charges (e.g. parking, etc

Key/Lock Last Month’s Rent Security Deposit Deposit on Account Balance Due Upon Acceptance

ARE YOU A CONVICTED FELON? (Y/N)

YES/NO*

Subject to Massachusetts law, the Management shall not make any inquiry concerning race, religious creed, color, national origin, sex, sexual orientation, age, (except if a minor), ancestry, gender identity, genetic information or marital status of the Applicant or concerning the fact that the Applicant is a veteran or a member of the armed forces or is handicapped. The Applicant authorizes the Management and/or Renting Agency to obtain or cause to be prepared a consumer credit report relating to the Applicant.

negligence. The undersigned warrants and represents that all statements herein are true and agrees to execute upon presentation a Rental Housing Association lease or Tenancy at Will agreement in the usual form, a copy of which the Applicant has received or has had occasion to examine, which lease or agreement may be terminated by the Lessor if any statement herein made is not true. Deposit is to be applied as shown above, or applied to actual damages sustained by the Owner, except it is to be refunded if said application is not accepted by the Owner. This application and deposit are taken subject to previous applications.

The Renting Agent is an independent contractor and has no authority to make any representation concerning the premises; the Renting Agent is only authorized to show the apartment for rent and to assist in the screening of Rental Applicants.

APPLICANT SIGNATURE

without the prior express written consent of the Greater Boston Real Estate Board. Form ID: RH101

GREATERBOSTONREALESTATEBOARD

Rental Application