Rental Application - Ccga Page 2
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4Rental Lease Application
Date:
_______
57 Mill Street
Woburn, MA 01801
781.933.1414 PH
781.933.8679 Fax
GENERAL INFORMATION
NAME OF APPLICANT
HOME PHONE NO.
EMAIL ADDRESS
IF RENTING, IS LEASE IN YOUR
CELL PHONE NO.
DATE OF BIRTH
SOCIAL SECURITY NO.
NAME?
LANDLORD’S NAME
PHONE NO.
PRESENT ADDRESS
DATES OF CURRENT OCCUPANCY
FROM
TO
MONTHLY RENT
PREVIOUS ADDRESS
PREVIOUS LANDLORD
PHONE NO.
DATES OF PREVIOUS OCCUPANCY
FROM
TO
HOW DID YOU HEAR ABOUT US?
MONTHLY RENT
EMPLOYMENT
OCCUPATION
COMPANY
PHONE NO. AND CONTACT NAME
HIRE DATE
WEEKLY GROSS SALARY
EMPLOYMENT (OTHER)
PHONE NO. AND CONTACT NAME
SCHOOL INFORMATION (student applicants only)
COLLEGE/UNIVERSITY
PROGRAM
YEAR OF GRAD
REGISTRAR’S OFFICE PHONE NO.
FULL OR PART TIME?
SCHOOL ADDRESS
PERSONAL INFORMATION
HAVE YOU EVER BEEN CONVICTED OF A FELONY? Y_____ N _____
IF YES, PLEASE EXPLAIN:
VEHICLE INFORMATION
YEAR
MAKE
MODEL
COLOR
STATE & PLATE NO.
YEAR
MAKE
MODEL
COLOR
STATE & PLATE NO.
CONTACT INFORMATION
IN CASE OF EMERGENCY (CONTACT NAME)
COMPLETE ADDRESS
PHONE NO.
APARTMENT INFORMATION
NAMES OF ALL CO-TENANTS (EACH ADULT MUST FILE A SEPARATE APPLICATION)
APARTMENT ADDRESS AND UNIT #
# OF BEDROOMS
TOTAL NUMBER OF OCCUPANTS
OCCUPANCY DATES
TERMS OF LEASE (MONTHS)
RENT COMMENCEMENT DATE
FROM
TO
COMMENTS (FOR OFFICE USE ONLY)
PAYMENTS
AMOUNT DUE
DATE DUE
BASE RENT PER MONTH
$
LAST MONTH’S RENT
$
SECURITY DEPOSIT
$
DEPOSIT RECEIVED
$
BALANCE DUE
$
This is an application form. The applicant understands that all information will be verified and credit bureau reports completed, of which the contents will be shared with the Landlord.
Until the Landlord has approved the application, no tenancy has been created and you have no rights to this apartment. The rental agent has no power to make any representations as to
whether or not this application has been accepted or denied by the Landlord. If denied, applicant's sole remedy shall be the return of any deposit made hereunder. Any person signing on
behalf of an applicant warrants and represents that said person has the authority to sign on behalf of such applicant. Any deposit hereunder shall be deemed made by such applicant
regardless of whether the applicant personally signs or through a representative and such representative by signing in such capacity waives all rights to such deposit. The undersigned
warrants and represents that all statements contained in this application are true, and recognized that the Landlord will execute a Lease in reliance upon the truthfulness thereof.
Applicant agrees to execute a Standard Apartment Lease, as from time to time revised, and on the terms and conditions contained herein. Any deposit made by applicant, up to one
month's rent, may be retained by Landlord as liquidated damages for failure of applicant to execute such Lease, make any payment hereunder, or if such Lease is terminated prior to
occupancy for the untruth of any statement contained herein.
Applicant’s Signature:
Date:
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