We do not ask for your date of birth, Social Security number, or driver’s license number on this application. If we offer you an apartment, we will collect what a credit and background check needs at that point, in person or on paper.

Dates as month and year, for example 03/2024. If you still live there, write “present”.

Include wages, self-employment, retirement, Social Security, SSI or SSDI, veterans’ benefits, child support, alimony, public assistance, and any rental assistance or housing subsidy. We accept housing vouchers. Any income standard we apply is applied only to your share of the rent.

Please do not write an account number in the credit reference field. The name of the bank or issuer is all we need.

Massachusetts law requires the following notice. In plain terms: if your record is sealed, you may answer “no record” here.

An applicant for employment or for housing or an occupational or professional license with a sealed record on file with the commissioner of probation may answer “no record” with respect to an inquiry herein relative to prior arrests, criminal court appearances or convictions.

Leeder Management does not discriminate on the basis of race, including natural and protective hairstyles, color, religious creed, national origin, ancestry, sex, pregnancy, gender identity or expression, sexual orientation, age, marital status, familial status or the presence of children, disability, genetic information, veteran or active military status, or receipt of public assistance or a rental subsidy, including Section 8 and other housing vouchers. Reasonable accommodations and modifications are available on request; ask us at any point and you need not disclose a diagnosis. Assistance animals are not pets and are not subject to pet policies, fees, deposits, or breed or weight limits. Equal Housing Opportunity.

By signing below you authorize Leeder Management to obtain a consumer credit report and to conduct a criminal background check, and you confirm that the information you have given here is true and complete. If we take an adverse action based in whole or in part on a consumer report, we will send you a written notice naming the reporting agency and telling you how to obtain a free copy of the report and dispute it. Before the tenancy begins we may collect only the first month’s rent, the last month’s rent, a security deposit not exceeding one month’s rent, and the actual cost of a new lock and key.

Sign the saved PDF, or sign it by hand after you print it.