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Massachusetts Rental Application is a rental application applied for a house or an apartment in the state of Massachusetts. This application is written on one page. This application can be divided into two sections. As an applicant, you should fill in all the spaces in the first section; you should read the second section carefully.

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RENTAL APPLICATION
2001 EDITION
(SUBJECT TO OWNER'S APPROVAL)
PREPARED BY:
_________________________________________
DATE NUMBER
__________________________________________________________________________________________________
NAME OF APPLICANT HOME PHONE INITIAL IF OVER 18 YEARS OF AGE
__________________________________________________________________________________________________
PRESENT ADDRESS DATES OF CURRENT OCCUPANCY: FROM TO
__________________________________________________________________________________________________
CITY* STATE AUTOMOBILE: MAKE/YEAR/REG STATE & NO. SOCIAL SECURITY #
__________________________________________________________________________________________________
PRESENT LANDLORD COMPLETE ADDRESS PHONE NUMBER
__________________________________________________________________________________________________
FORMER LANDLORD OCCUPANCY COMPLETE ADDRESS PHONE NUMBER
__________________________________________________________________________________________________
CURRENT EMPLOYER COMPLETE ADDRESS PHONE NUMBER
__________________________________________________________________________________________________
OCCUPATION/SOURCE OF INCOME TYPE OF BUSINESS SALARY LENGTH OF EMPLOYMENT
__________________________________________________________________________________________________
FORMER EMPLOYER LENGTH OF EMPLOYMENT COMPLETE ADDRESS PHONE NUMBER
__________________________________________________________________________________________________
PERSONAL REFERENCE (NAME) COMPLETE ADDRESS PHONE NUMBER
__________________________________________________________________________________________________
IN CASE OF EMERGENCY NOTIFY (NAME) COMPLETE ADDRESS PHONE NUMBER
__________________________________________________________________________________________________
CREDIT REFERENCE COMPLETE ADDRESS PHONE NUMBER
__________________________________________________________________________________________________
BANK-CHECKING ACCOUNT BRANCH ADDRESS ACCOUNT NUMBER
__________________________________________________________________________________________________
BANK0SAVINGS ACCOUNT BRANCH ADDRESS ACCOUNT NUMBER
__________________________________________________________________________________________________
NAMES OF ALL CO-TENANTS (EACH ADULT MUST FILE A SEPARATE APPLICATION)
_____________________________________________________________
APARTMENT NO/TYPE TOTAL NO. OF OCCUPANTS NO. OF ADULTS NO. OF PETS
_____________________________________________________________
ADDRESS NAMES & AGES OF MINOR CHILDREN
_____________________________________________________________
CITY OCCUPANCY DATE RENT BEGINS
_____________________________________________________________
TERM OF LEASE (MONTHS) FROM (DATE) TO (DATE)
Base rent per month $
____________________
(Subject to escalation as set forth in lease)
Other Monthly Charges (e.g. parking, etc.)
_______________ _______________
Key/Lock
____________________________
Last Month's Rent
_______________________
Security Deposit
________________________
Deposit on Account
______________________
Balance Due
__________________________
Upon Acceptance
_______________________
Base Rent and Other Monthly Charges are due and payable on the first day of each month in advance.
Pursuant to Massachusetts law, the Management shall not make an inquiry concerning race, religious creed, color, national am, 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 Association lease 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 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. 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 agent is only authorized to show the
apartment for rent and to assist in the screening of rental applicants.
________________________________________________ ____________________________________________
Renting Agent Signature
COPYRIGHT © 1969
GREATER BOSTON REAL ESTATE BOARD
All rights reserved. This form may not be copied or reproduced
in whole or in part in any manner whatsoever without the prior
express written consent of the Greater Boston Real Estate Board.
Form No. RH101 CWV 1.0
Massachusetts Rental Application
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