Sample Form
Rental Application
(Subject to Owner's Approval)
Name of Applicant |
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Home Phone |
Initial if over 18 yrs of age |
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Present Address |
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Dates of Current |
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Occupancy: |
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From |
Mo. Yr |
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To: |
Mo. Yr. |
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City |
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State |
Automobile Make&Yr |
Social Security # |
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Reg (State&No.) |
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Present Landlord |
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Complete Address |
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Phone Number |
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Former Landlord |
Occupancy ___ Years |
Complete Address |
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Phone Number |
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Current Employer |
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Complete Address |
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Phone Number |
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Occupation or Source of Income |
Type of Business |
Salary |
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Length of Employment |
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Former Employer |
Length of employment |
Complete Address |
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Phone Number |
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Personal Reference (Name) |
Complete Address |
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Phone Number |
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In Case of Emergency Notify (Name) |
Complete Address |
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Phone Number |
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Credit Reference |
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Complete Address |
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Phone Number |
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Bank-Checking Account |
Branch Address |
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Account Number |
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Bank-Savings Account |
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Branch Address |
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Account Number |
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Names of all co-tenants (each adult must file a separate application) |
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Apartment No. Or |
Total Number of |
Number of Adults |
Pets |
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Base rent per month $_____ |
Type |
Occupants |
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(Subject to escalation as set |
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for in lease) |
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Address |
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Names&Ages of Minor Children |
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Other Monthly charges_____ |
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Placement Fee_______ |
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City |
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Occupancy Date |
Rent Begins |
Key/Lock____________ |
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Last Month's Rent ________ |
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Terms of lease |
From (Date) |
To (Date) |
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Security Deposit________ |
(months) |
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Deposit on Account |
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Base rent&other monthly charges are due & payable on the first day of each month in advance |
Balance Due Upon |
Acceptance __________
Sample Form
Rental Application
(Subject to Owner's Approval)
Pursuant to Massachusetts law, the Management shall not make any inquiry concerning the race, religious creed, color, national origin, sex, age (except if a minor), ancestry, 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 blind. Neither the Owner nor the Management is responsible for the loss of personal belongings caused by fire, theft, smoke, water, or otherwise, unless caused by their negligence. The undersigned warrants and represents that all statements herein are true and agrees to execute upon presentation of a Rental Housing 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, 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.
THIS APPLICATION MUST BE ACTED UPON BY THE OWNER ON OR BEFORE ____________________________________
The renting agent is an independent contractor and has no authority to make any representation concerning the premises; the
renting agents only authorized to show the apartment for rent.
Copyright 1967, 1969, 1970
Greater Boston Real Estate Board
Adopted by the Rental Housing Association of the Greater Boston Real Estate Board
