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Chicopee, Windsor Court

            Madison Square Realty Management, Inc.
                            Rental Application
            Telephone:  413-746-9846            Fax: 413-746-9848
 
Credit Background check is performed
Picture ID required with this application
                            PLEASE PRINT LEGIBLY
Property Name:                            
Apartment Number:         
 
Number of Persons to occupy the apartment:             
 
1.YOUR INFORMATION:
APPLICANT'S FULL NAME:                                       DATE OF BIRTH                
Social Security Number:                      Driver's License Number:                   
 
CO-APPLICANT'S FULL NAME:                                       DATE OF BIRTH                
Social Security Number:                      Driver's License Number:                   

 

 Full Name of All Other ResidentsAge Relationship to You Date of Birth 
    
    
    

 

Do You Have a Pet?      Yes       No

 

If Yes, What Kind?                                              

 

Are you aware that our no pet policy permits no pets unless you have the express written  

 

permission of Management to have a pet your lease expressly allows it?   Yes    No

 

How did you hear about our property?   Newspaper       Internet      Referral  Other                                                                             

 

 

 

2. RESIDENCE INFORMATION

 

PRESENT ADDRESS:                                                                                                                                     

 

Present Tel:                        Residency Dates:  From            to           

 

Present Landlord and Management Company:                                                                                              

 

Management/Landlord Telephone:                              Monthly Payment:                              

 

Reason for Moving:                                                                                                                                         

 

PREVIOUS ADDRESS:                                                                                                                                   

 

Previous Telephone:                                 Residency Dates:  From                           to                               

 

Previous Landlord and Management Company:                                                                                              

 

Previous Management/Landlord Telephone:                                          Monthly Payment:                              

 

Reason for Moving:                                                                                                                                       

 

Co-Applicant's Present Landlord/Management Company, Address and Telephone:

 

                                                                                                                                                                  

 

Co-Applicant's Previous Landlord/Management Co., Address and Telephone:

 

                                                                                                                                                               

 

 3. EMPLOYMENT HISTORY

 

PRESENT EMPLOYER:                                                                                       

 

Present Employer's Address:                                                                                                        

 

Employer's Tel:                    Employment Dates: From                  to                          

 

Position:                                        Supervisor:                                           

 

Gross Monthly Salary:                     

 

 

 

PREVIOUS EMPLOYER:                                                                                       

 

Previous Employer's Address:                                                                                                        

 

Employer's Tel:                 Employment Dates: From                    to                           

 

Position:                                        Supervisor:                                           

 

Gross Monthly Salary:                     

 

 Co-Applicant's  EMPLOYER:                                                                                       

 

Present Employer's Address:                                                                                                        

 

Employer's Tel:                   Employment Dates: From                  to                               

 

Position:                                        Supervisor:                                           

 

Gross Monthly Salary:                     

 

   

 

 

 

 

 

  4. BANKING AND CREDIT REFERENCES:

 

  

 BANK NAME/CREDIT CARDTELEPHONE CHECKING ACCT. SAVINGS ACCT. CREDIT ACCT. 
     
     
     
     

 

 OTHER REFERENCES:                                                                                                                                                                                      

 

 

 

5. VEHICLES: Must be registered with and must have MSRM tag(s).

 

 Make/ModelYear Color Plate/Tags/State 
    
    
    

 

6. OTHER INFORMATION:

 

Have you or any other prospective resident ever been convicted of

 

any crime?   Yes        No

 

If yes, please explain:                                                                                                                            

 

-Have you or the co-applicant ever been sued for

 

  non-payment of rent?  Yes     No

 

-Have you or the co-applicant ever been

 

   evicted or asked to move-out?    Yes     No

 

-Have you or the co-applicant broken

 

    a rental agreement or Lease?           Yes     No

 

-Have you or the co-applicant been sued

 

      for damage to rental property?    Yes    No

 

 

 

  

 

7. Emergency:

 

In case of emergency, Notify:                                                    Relationship                                   

 

      Address:                                            Home Phone:                            Cel.                                    

 

      Work Phone:                                                          

  1. I agree to comply with all House Rules and Lease obligations of the apartment complex for which I am applying.
  2. It is unlawful to discriminate against prospective tenants on the basis of race, religion, national origin, age or disability
  3. All applications are subject to owner approval.
  4. I agree to obtain renter insurance
  5. Management/Owner not responsible for my property
  6. I represent that all statements herein are true and any false representations are grounds for denial of application
  7. False statements in this application are also grounds for termination of tenancy.
  8. In connection with my application for this apartment, I authorize:
  9. all banks, corporations, companies, credit agencies,  persons and employers,
  10. to release any information that they have about me to Management/Owner or its agent,
  11. and I release them from any and all liability or responsibility from doing so. 
  12. Further, I authorize the procurement of  an investigative consumer report 
  13. and a possible criminal background check and understand that such report may
  14. contain information about my background, character and personal reputation. 
  15. I understand this authorization will also apply to future updated reports that may be requested,
  16. even after my tenancy/residency if arrears are owed.  As always, reasonable accommodations provided to those with disabilities. 

 

 

 

Applicant's Signature:                               Date:                       

 

 

 

Co-Applicant's Signature:                           Date: