Nick's Realty Trust

PRINTABLE RENTAL APPLICATION

DATE____________________

Rental is subject to Owner’s approval and verification of the information below

A. Applicant Information

1. Applicant Name__________________________________________________________________________________

2. Address________________________________________________________________________________

3. Telephone Home________________________ Cell_____________________Work____________________

4. Social Security Number____________________________________________________________________

B. Occupants

5. How many occupants of Rented Premises will there be?__________________________________________

C. Applicant’s Rental History

6. Length of Time at Current Address (in item A)_________________________________________________

7. Name of Present Landlord__________________________________ Telephone______________________

8. Previous Address________________________________________________________________________

9. Length of Time at Previous Address__________________________________________________________

10. Previous Landlord________________________________________ Telephone_______________________

D. Applicant’s Employment/Financial Background

Length of Time

11. Current Occupation___________________________________in Position___________________________

12. Employer’s Name & Address_______________________________________________________________

13. Employer Contact Name & Telephone ________________________________________________________

14. Current Salary __________________________________________________________________________

15. Educational Background (if applicable)_______________________________________________________

16. Name & Address of Your Bank ___________________________________________________________

17. Checking Acct. No. _________________________________Savings Acct. No. ______________________

18. Other Sources of Income __________________________________________________________________

19. Other References ________________________________________________________________________

E. Applicant’s Vehicles

20. Number of Vehicles to be Parked at Rented Premises _______________________________________

21. Description of All Vehicles:

Make/Model Year Color State License Plate #

________________________ ____________ _____________ _____ _____________________

________________________ ____________ _____________ _____ _____________________

_______________________ ____________ _____________ _____ _____________________

F. Miscellaneous

22. Have you ever:

A. been evicted? Yes No

B. failed to timely pay rent? Yes No

C. filed for bankruptcy? Yes No

Please explain below if you checked “Yes” for any items:

G. Size of Apartment Interested In

23. Studio ÿ One Bedroom ÿ Two Bedroom ÿ Room ÿ

24. Deposit Amount Received to Hold Apartment__________________________________________________

25. Application Fee Amount Received ______________________________________6. Date______________

DISCLOSURE/AGREEMENT/CONSENT

1. I/We understand that ________________________is an agent of the Landlord and is a paid representative of the Landlord. I/We acknowledge that this written notice was received before I/We received a rental agreement

2. I/We authorize you to conduct an employment/credit check concerning my/our application and to verify all references.

3. I/We declare that all information listed on this application is true and accurate.

4. Tenants at their decision may purchase and provide their own apartment insurance. Nick’s Realty Trust is not responsible for personal property.

____________________________________ ______________

Applicant’s Signature Date

______________________________________ ______________

Co-Applicant’s Signature Date

______________________________________ ______________

Application Received By Date

______________________________________

Title

Please mail or return this application in person to the offices of Nick’s Realty Trust, 46 Chauncy Street, Mansfield, MA 02048 (508) 339-9556