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Brokerage
Agreement /Application |
MAIN LEASING
OFFICE
TOLL FREE PHONE: 914-834-8200
FAX: 914-834-8065 |
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| Date: ______ How did you here about us:_____________
Preferred move-in date: _____ Bldg/Unit #: ____ |
| Applicant Name(s) |
| Name: |
Name: |
| Address: |
Address: |
| City:_________ State: _________ Zip:_________ |
City:_________ State: _________ Zip:_________ |
| Phone:__________ Other Phone: __________ |
Phone:__________ Other Phone: __________ |
| Soc. Sec. #: _____ - _____- _____ DOB __________ |
Soc. Sec. #: _____ - _____- _____ DOB __________ |
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| Tenant History |
| Reason for move: |
Reason for move: |
| Present Landlord: |
Present Landlord: |
| Phone: |
Phone: |
| Years at present address:_____ Current Rent:______ |
Years at present address: _____ Current Rent:______ |
| Prior Add: (if less than 2 yrs). |
Prior Add: (if less than 2 yrs). |
| Years at Prior Address: |
Years at Prior Address: |
| Previous Landlord: ____________ Phone: __________ |
Previous Landlord: ____________ Phone: __________ |
| Has either LL ever sued for non-payment of rent ? |
Has either LL ever sued for non-payment of rent ? |
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| Employment Information |
| Employer: |
Employer: |
| Address: |
Address: |
| Position: |
Position: |
| Salary: Per: |
Salary: Per: |
| How long employed: |
How long employed: |
| Supervisor: |
Supervisor: |
| Phone: |
Phone: |
| Other source of income: |
Other source of income: |
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| Credit Information |
| Credit Cards: |
Credit Cards: |
| Bank Name: _______________ Savings Acct#:_______________ |
Bank Name: _______________ Savings Acct#:_______________ |
| Bank Name: _______________Checking Acct#:_______________ |
Bank Name: _______________Checking Acct#:_______________ |
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| Occupancy Details |
| Names of all persons who will occupy apartment:
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Soc. Security #: |
Relationship to Applicant: |
Age: |
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| Auto Information |
| Auto Make |
Model |
Year |
Plate |
Auto Make |
Model |
Year |
Plate |
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| Pet Information |
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| Emergency Contacts (in case of emergency contact) |
| Name: |
Phone: |
| Name: |
Phone: |
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| Guarantor Information |
| Name of Guarantor: |
Phone: |
| Address: |
Social Sec. # ____ - ____ - ____ |
I hereby authorize
Landlord authorizes the Landlord and its associates, credit bureau’s,
Banks, Financial Institutions, Attorney’s, Accountants and other
persons or institutions with whom I am acquainted to furnish any
information regarding me. I am willing that a photocopy or facsimile
of this authorization be accepted with the same authority as the
original. |
Signature of Guarantor x______________________ |
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| Character Reference |
| Character Reference Name: |
Character Reference Name: |
Address:
Phone: |
Address:
Phone: |
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It is hereby agreed that upon execution
of this application, said applicant shall deposit with the Landlord, and/or
its agent, a non-refundable fee of $ 40.00 per applicant to pay for the
cost of checking the applicant’s credit history. Applicant hereby authorizes
the Landlord and its associates, credit bureau’s, Banks, Financial Institutions,
Attorney’s, Accountants and other persons or institutions with whom I
am acquainted to furnish any information regarding me. I am willing that
a photocopy or facsimile of this authorization be accepted with the same
authority as the original. It is agreed that this application is subject
to acceptance or rejection at any time by the Landlord at its sole discretion.
This fee shall be non-refundable if the Applicant withdraws this application
for any reason whatsoever. |
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Applicant Signature: ________________________________________
Co-Applicant: _____________________________________________ |
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