117 West 70th Street - Online Rental Application Form

117 West 70th Street Application

Upper West Side Premier SRO Units
Full Name*

First NameLast Name
E-mail*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
YesNo
Current Employer
Length of Employment
Monthly Salary (USD)
Address of Current Residence

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Preferred Move in Date

MonthDayYear
Preferred Floor Plan*
How will you be covering your rent? *
YesNo
Please describe all pets
YesNo
YesNo
If you answered yes to any of these questions, please explain:
New York State Housing and Anti-Discrimination Disclosure

Federal, State and local Fair Housing and Anti-discrimination Laws provide comprehensive protections from discrimination in housing. It is unlawful for any property owner, landlord, property manager or other person who sells, rents or leases housing, to discriminate based on certain protected characteristics, which include,but are not limited to race, creed, color, national origin, sexual orientation, gender identity or expression, military status, sex, age, disability, marital status, lawful source of income or familial status. Real estate professionals must also comply with all Fair Housing and Anti-discrimination Laws.
I Acknowledge that I have read and understand my rights under NYC Fair Housing Laws
By submitting this application you agree: 1) The information provided herein is complete and accurate. Providing incomplete and/or false information could result in the rejection of the application. 2) Submission of this application does not guarantee a room lease, which is reserved only upon signing of a completed lease agreement by all parties. Additionally, no other agreements, either written or oral, are binding on applicant, owner or owner's agents until the completed lease agreement is signed by all parties. 3) Additional information may be required in order to process your application. Our leasing agent Niccol Gordon will contact you upon receipt of this online application to obtain any additional information necessary to complete the processing of your application.
I Agree
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117 West 70th Street Application