APPLICATION FORM
Please fax COMPLETED application to
Director of Leasing at (718)933-1386
Application Fee:
$275.00
MAIN APPLICANTCO-APPLICANT
Last Name First Name
Middle Name Date of Birth
Social Security # 		Last Name First Name
Middle Name Date of Birth
Social Security #
CONTACT
Home # Work # Ext
Cellular # Personal E-mail
Beeper # Work E-mail 		Home # Work # Ext
Cellular # Personal E-mail
Beeper # Work E-mail
EMPLOYMENT HISTORY
Company Name Position/Title
Address City, State, Zip:
Employment Start Date Annual Salary
Supervisor's Name Supervisor Tel 		Company Name Position/Title
Address City, State, Zip:
Employment Start Date Annual Salary
Supervisor's Name Supervisor Tel
CURRENT RESIDENCE
Address City, State, Zip
Landlord Name Tel
Date Lived there to Monthly Rent: 		Address City, State, Zip
Landlord Name Tel
Date Lived there to Monthly Rent:
 
COMPANY INFORMATION
Legal Name
DBA
Address, Unit
City, State, Zip
Landlord's Name
Current Monthly Rent
Tax ID
Date Entity Created
Officers Names and Positions (List All)
Entity Type
Name Position Yrs W/Co
Name Position Yrs W/Co
No. of Employees
How did you hear about this space?
DOCUMENTS TO BE SUBMITTED WITH APPLICATION (please check off all documents submitted with this application)
Income Tax Returns - 3 Years Driver's License, Social Security Card and W2
Bank Statements (3 months) for Personal and Business Personal Finance Statement / Entity Formation

I hereby authorize Mastermind and a credit reporting agency to conduct inquiries concerning my income, residences, family composition, businesses and character for the purpose of verifying information provided by me on my commercial rental application to the above named property. I understand that a full disclosure of pertinent facts may be made to the landlord and any misrepresentation by me may be cause for rejection by the landlord. I, Tenant/Applicant, understand and agree that the fee paid is non refundable should I be rejected and that I have no recourse whatsoever against the managing agent or the Landlord. A certificate of insurance must be produced by lease signing. No application is finalized until the lease is signed nor does the submission of application guarantee the applicant for the space until lease is signed.


Applicant's Signature:__________________________________ Co-Applicant's Signature:_________________________________

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