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Please use Word document or PDF from the left frame of this website and Email to Info@bandbrealty.com
Please answer all that apply
# Bedrooms Desired Property Address you desire
Number of Vehicles
Name1 Tel Num
Email Cell Num
Soc Sec # DOB
Employer Name Tel Num
Auto Make Model Year
Name2 Tel Num
How Long Employed Amount of Income(per month)
Landlord Name Tel Num
How long at this address? Rent Amount Incl. Heat?
Reason for Leaving
Previous Address (please include City, State, Zip code)
How long at this address?
Do you own pets? Number Kind
Do you own Refrigerator Stove
Name1 Tel Num Relation
Name2 Tel Num Relation
Have you always been on time with your rent payments?
Taken to Court?
true and can be used and considered to obtain credit information by Jim Boone
and or Gisele Boone, and or Wayne Arsenault, Trustees, B & B Realty Trust and North
Central Investments Trust, 50 Ash Street, Gardner MA 01440
in granting me(us) the privilege of renting the premises herein.
(required)*Please indicate "Yes" here
A fee of $15.00 may be requested to obtain a credit report.
If submitted electronically signatures will be obtained at time of showing or prior to Rental.
Name1 (please print) Signature
Name2 (please print) Signature
* Rent is Due on or before the 1st of each month.
* Rent not received by the first will require an additional $25.00 late fee.
* 3 Late payments will constitute an eviction.
* Noise will NOT be tolerated and will constitute an eviction.
* Pets are NOT allowed unless specific written permission.
* Stove and Refrigerator are Not provided.
Cleaning Deposit $ ___________
Key Deposit $ ___________
Before sending be sure to enter the required field, use Back button if error occurs.
Please take picture and email or use PDF or Word document found in the frame on the left.
- Dont click will not send to us.