Personal Information

Home Phone

SS #:

City, State:

Resided 

Auto Make & Model:

Name:

Street Address:
City, State:

Name:

Street Address:
City, State:

Street Address:
City, State:

Phone:

Former Employer

Street Address:
City, State:

Phone:

Reference and Contacts

Credit Reference

Apartment Information

Base rent and other monthly charges are due on the first day of each month in advance. Pursuant 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, 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. 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 a Rental Housing Lease agreement in the usual form a copy of which the applicant will have the occasion to examine, which lease may be terminated by the lessor if any statement herein made is not true. Deposit is to be applied to last months rent, except it is to be refunded if this application is not accepted by the owner. This application and deposit are taken subject to previous applications.