879 Beacon Street, Boston MA 02215    Tel: (617) 388-5881     Fax (617) 536-3299     Email: nuscott05@hotmail.com

This form shall be construed as a rental application and offered to: _____________________________________________________ (Landlord/R.E. name) for unit # _______  at ____________________________________ (street address) _____________________________________________________ (city, state & zip) This application includes a deposit in the amount of $_____________ to be used towards the first month’s rent upon acceptance of this offer to rent. Rent per month is $_______ Term of lease: _____________ (months) _______ (days) Lease to start: _____________________ and terminate on: _____________________ Additional monies due upon acceptance of this application by the landlord include: First month’s rent: $_______  Last month’s rent: $_______  Security deposit: $_______ Key deposit: $_______          Parking deposit: $_______     Other: $_______  The following utilities are due in addition to the rent: _____________________________   Name:______________________________________ Social Security #: ___________ Current Address: Street: ______________________________________________________ Apt #: ____ City: ______________________________________ State: ___________ Zip: _______ Phone: Day: _________________  Eve: __________________ Cell: ________________ Email Address: ______________________ Website: ____________________________   Current Landlord: _______________________________________________________ Street: _____________________________________________________ Suite #: ____ City: ______________________________________ State: ___________ Zip: _______ Phone: Day: _________________  Eve: __________________ Cell: ________________ Email Address: ______________________ Website: ____________________________   Previous Address: Street: ______________________________________________________ Apt #: ____ City: ______________________________________ State: ___________ Zip: _______   Previous Landlord: _______________________________________________________ Street: _____________________________________________________ Suite #: ____ City: ______________________________________ State: ___________ Zip: _______ Phone: Day: _________________  Eve: __________________ Cell: ________________ Email Address: ______________________ Website: _____________________________   Previous Address: Street: _______________________________________________________ Apt #: ____ City: ______________________________________ State: ___________ Zip: _______   Previous Landlord: Street: _____________________________________________________ Suite #: ____ City: ______________________________________ State: ___________ Zip: _______ Phone: Day: _________________  Eve: __________________ Cell: ________________ Email Address: ______________________ Website: _____________________________   Current Employer: __________________________Current job:_____________________ Name of Company Contact: ________________________ Title: _________________ Street: _____________________________________________________ Suite #: ____ City: ______________________________________ State: ___________ Zip: _______ Phone: _________________  Fax: _______________ Email Address: _______________ Website: _____________________________   Previous Employer: ________________________ Previous job: _____________________ Name of Company Contact: ________________________Title: _____________________ Street: _____________________________________________________ Suite #: ____ City: ______________________________________ State: ___________ Zip: _______ Phone: _________________  Fax: _______________ Email Address: _______________ Website: _____________________________   Credit References Name of Bank for Checking: ________________________ Account #: ______________ Name of Bank for Savings: _________________________ Account #: ______________ Name of Credit Card or Loan: ______________________  Account #: ______________   I hereby certify that I am over 18 years of age and that the above application is true. I also give the landlord or its agents permission check my credit and contact the above mentioned references for the purpose of applying for the aforementioned apartment.     _________________________________ Applicant’s Signature and date Application copyright Boston Apartments.comSM All rights reserved.