AMA

(781)-662-9000 Tel                         2005 EDITION                      (781)-662-2200 Fax

RENTAL APPLICATION

(Subject to owner’s approval)

DATE _____/_____/2005                                    INITIAL IF OVER 18 YEARS OLD____________

____________________(_____)______________________/____/_____________

NAME OF APPLICANT                            HOME PHONE                            SOCIAL SECURITY #

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PRESENT ADDRESS                 AMOUNT PAID          DATES OF CURRENT OCCUPANCY: FROM TO: ______________________________________________________________________________________________

CITY                    STATE              ZIP               AUTOMOBILE -MAKE  YEAR   NUMBER PLATE    STATE

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E-MAIL ADDRESS HOME WORK

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PRESENT LANDLORD                    ADDRESS                                                               PHONE NUMBER

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FORMER LANDLORD                 ADDRESS            YEARS. THERE                            PHONE NUMBER

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FORMER LANDLORD                 ADDRESS            YEARS THERE                              PHONE NUMBER

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CURRENT EMPLOYER               ADDRESS                                                                    PHONE NUMBER

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OCCUPATION                   TYPE OF BUSINESS        YEARS. THERE SALARY: WEEK/ MONTH// YEAR

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PERSONAL REFERENCE (NAME)           ADDRESS                                                        PHONE NUMBER

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IN CASE OF EMERGENCY NOTIFY (NAME)       ADDRESS                                         PHONE NUMBER

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NAMES OF ALL CO-TENANTS (EACH ADULT MUST FILE A SEPARATE APPLICATION)

_______________Base rent per month____________________ TOTAL NO. OF OCCUPANTS_____ NO. OF ADULTS_____ NO. OF PETS_________ Last Months rent _________________

__________________________________________________Security deposit_____________________ NAMES & AGES OF MINOR CHILDREN                                Lock Charge________________________                                                                           Rental Agent fee _______________________ __________________________________________________________________________________________                                                                                                        Amount Due

ADDRESS APT # CITY                                                     Upon Acceptance _________________________

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TERM OF LEASE (MONTHS)                    OCCUPANCY DATE FROM TO

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 any inquiry concerning the 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 undersigned warrants and represents that all statements herein are true and agrees to execute upon presentation an Action Management Associates 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.

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. The applicant authorizes Action Management Associates, Inc. Rental Division to obtain a consumer credit report relating to the applicant

RENTING AGENT______________________ APPLICANT SIGNATURE  __________________________