2010 Rental Application Worksheet Template
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1RENTAL APPLICATION 2010
(SUBJECT TO OWNERS APPROVAL)
East Coast Realty
555 Columbus Ave
Boston, Ma. 02118
Date_______________
617-536-2900 Office
617-859-3919 Fax
How did you hear about East Coast Realty? __________________________
___________________________________________________________________________________________
NAME OF APPLICANT
CELL PHONE
E-MAIL
___________________________________________________________________________________________
SOCIAL SECURITY NUMBER
PRESENT ADDRESS
CITY
STATE
ZIP CODE
___________________________________________________________________________________________
PRESENT LANDLORD
PHONE NUMBER
DATES OF CURRENT OCCUPANCY
FROM
TO
___________________________________________________________________________________________
MOTHER’S NAME
MOTHER’S CELL PHONE
MOTHER’S E-MAIL
___________________________________________________________________________________________
FATHER’S NAME
FATHER’S CELL PHONE
FATHER’S E-MAIL
___________________________________________________________________________________________
PERMANENT HOME ADDRESS (NOT SCHOOL ADDRESS)
CITY
STATE
PHONE NUMBER
___________________________________________________________________________________________
OCCUPATION / SOURCE OF INCOME
TYPE OF BUSINESS
SALARY
LENGTH OF EMPLOYEMENT FROM
TO
___________________________________________________________________________________________
PERSONAL REFERENCE (NAME)
ADDRESS
E-MAIL
PHONE NUMBER
___________________________________________________________________________________________
EMERGENCY CONTACT (NAME)
ADDRESS
E-MAIL
PHONE NUMBER
___________________________________________________________________________________________
CREDIT REFERENCE (CREDIT CARD/ CELL PHONE CARRIER)
BANK NAME
___________________________________________________________________________________________
NAME OF ALL CO-TENANTS (ROOMATES) (EACH TENANT MUST FILE A SEPARATE APPLICATION)
TOTAL NUMBER OF TENANTS
___________________________________________________________________
AMOUNT
DUE BY
ADDRESS
City
First Month's Rent
$
____________________________________________________________________
Last Month's Rent
$
TERM OF LEASE (MONTHS)
FROM (DATE)
TO (DATE)
Security Deposit
$
____________________________________________________________________
WHAT UTILITIES ARE INCLUDED IN THE RENT?
PETS?
App Fee/Credit
$
Check
Are you a convicted felon? (Y/N) ______ If ‘Yes’ Please submit detail of
Key/Lock
$
conviction(s).
Tenant Fee
$
Base rent and other monthly charges are due and payable on the first date of
each month in advance. Pursuant to Massachusetts law, the Management shall
Landlord Fee
$
not make any inquiry concerning race, religious creed, color, national origin, sex,
sexual orientation, age, (except for a minor), ancestry or marital status of the
Today's Deposit
$
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
Balance Due
$
and/or Renting Agency to obtain cause to be prepared a consumer credit report
relating to the Applicant
Neither the Owner nor the Management is responsible for the loss of personal belongings cause by fire, theft, smoke, water, or otherwise unless
cause by their negligence.
The undersigned warrants and represents that all statements herein are true and agrees to execute upon the presentation a Rental Housing
Association 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 of 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.
Applicants acknowledge that this deposit is non-refundable unless rejected by the landlord and that East Coast Realty is still due a commission
if the applicants decide not to move in.
Renting Agent _________________________________________
Applicant Signature ________________________________________
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