Rental Brokerage Fee Disclosure

All real estate offices/agents are required by state regulation to provide a fee disclosure form to prospective tenants. This agency collects a fee for services rendered towards securing your rental housing equal to one month’s rent; market conditions and individual landlord/tenant preferences will dictate what portion of that one month fee is to be paid by you, the applicant(s). Your fee obligation for a particular rental unit cannot be identified until you select an apartment for which you intend to apply, at which time applicant(s) agree to complete the following:

Unit Address

Fee due

applicant(s) initial(s)

The above-stated fee is due to the agency immediately after you have submitted complete application materials and been notified by our office of your acceptance by the landlord for tenancy. If you are not approved for tenancy or if the landlord cannot provide the apartment after acceptance, no fee is due our office.


The undersigned prospective tenants understand that if he/she is part of any group that

has been shown rental property by our agent(s) yet proceeds to lease the premises through any other source, including broker, management company or landlord, a fee equal to one month’s rent will be due to this agency prior to occupancy date.


The undersigned acknowledge that all deposit monies made payable to the agency, except our fee, will be cleared through our escrow account and turned over to the lessor to secure the apartment and fulfill the lease requirements. The undersigned authorize the agency to release these funds and acknowledge that our office assumes no responsibility for these funds once released. Also, any payments towards any rental transaction received within 14 days prior to occupancy must be paid by bank check, money order or cash; personal checks will not be accepted.

***all prospective tenants must sign prior to or at the time of application***

Tenant________________________________ Tenant_________________________________

Tenant________________________________ Agent__________________________________

Tenant________________________________ Date___________________________________

Tenant________________________________ Agency________________________________

This form is courtesy of