Rental Application

$30 due upon submission per application

Delapa Properties

511 Washington Street

P O Box 277

Norwood, MA 02062

Phone (781) 769 - 3429 Fax (781) 769 - 4769

Application will automatically be denied if not completely filled-in. A separate application must be filled out by each applicant 18 or older (even if married).

PERSONAL INFORMATION

APPLICANT______

CELL PHONE (______)______SSN# ______DOB ___ /__ /______

HOME PHONE (______)______

EMAIL ADDRESS______

DRIVERS LICENSE#______STATE ISSUED: ______

ADDRESSES

CURRENT ADDRESS______Street City State Zip

Street City State Zip

RESIDING SINCE MONTHLY RENT $ ______

ARE UTILITIES INCLUDED? Y/N IF YES WHICH ONES______

CURRENT LANDLORD NAME AND COMPLETE ADDRESS:

______(_____)______

Street City State Zip Phone

Is current rent up to date? q Yes q No

Have you given notice? q Yes q No

Have you been asked to leave? q Yes q No

If yes, Please Explain:

______

Do we have permission to contact your landlord q Yes q No

PREVIOUS ADDRESS:______

Street City State Zip

RESIDED SINCE MONTHLY RENT $ WERE UTILITIES INCLUDED?____

PREVIOUS LANDLORD NAME AND ADDRESS ______(____)______

Street City State Zip Phone

Was the rent up to date? q Yes q No

Did you give notice? q Yes q No

Were you asked to leave? q Yes q No

If Yes Please Explain:

______Do we have permission to contact your landlord q Yes q No

COMPLETE ON REVERSE SIDE→→

EMPLOYMENT

NAME OF COMPANY ______

COMPANY ADDRESS :______(___)______

Street City State Zip Phone

CURRENT SALARY : $______(wkly/mnthly/annual) Circle one

LENGTH OF EMPLOYMENT ______POSITION______

SUPERVISOR ______PHONE (_____)______,

ADDITIONAL INCOME SOURCES:______

______

PREVIOUS EMPLOYMENT

PREVIOUS INCOME $______(wkly/mnthly/annual) Circle one

SUPERVISOR ______PHONE (_____)______,

CHILDREN

NAME/S OF CHILDREN AGE/S

______

______

PETS: q Yes q No If yes, give details (number, type, size)______

AUTOMOBILES

MAKE______MODEL______COLOR ______STATE___ LIC. PLATE ______

MAKE______MODEL______COLOR ______STATE___ LIC. PLATE ______

ARE YOU A CONVICTED FELON?(Yes/No) If YES Please submit details of conviction.

IN CASE OF EMERGENCY NOTIFY:

______(_____)______

Street City State Zip Phone

Pursuant to Massachusetts Law, the Management shall not make any inquiry concerning the race, religious, creed, color, national origin, sex, 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 blind.

Applicant authorizes the owner to contact past and present landlords, employers, creditors, credit bureau, and any other sources deemed necessary to investigate applicant.

All the information is true, accurate and complete to the best of applicant's knowledge. Owner reserves the right to disqualify tenant if information is not as represented.

ANY PERSON OR FIRM IS AUTHORIZED TO RELEASE INFORMATION ABOUT THE UNDERSIGNED UPON PRESENTATION OF THIS FORM OR A PHOTOCOPY OF THIS FORM AT ANY TIME

X______

APPLICANT DATE:

Unit you are applying for (include City, State, Street and Unit number)______

Agent who showed Unit to You______