Information Request Form

As required by Massachusetts State law, MGL, Chapter 183A and Chapter 51:10A of The Acts of 1991 and Chapter 400 of the Acts of 1992, please fill out this form and return it to BRW, 252 Newbury Street, Boston, MA 02116. If there are any changes in tenants or mortgage companies, fill out a new form as they come due.

Owner(s) Name:
Address/Unit #
Owner's Current Address
Date of Unit Purchase
Sale Price
Owner's Home Phone
Owner's Work Phone
Owner's Cell Phone
Owner's E-mail
Emergency Contact
If your rent your unit, please fill out the below info:
Names of Tenants:
Tenant 1.
Tenant 2.
Tenant 3.
Tenant's Phone #
Home Phone:
Work Phone
If there is a mortgage on your unit, please fill out the following:
First Mortgage (Lender)
Lender's Address
Loan #
Lender's Contact Name
Lender's Contact Phone #
If you have more than one mortgage, please provide the same information in the below box. Any changes to the above information must be forwarded to us within 30 days.



252 Newbury Street, Boston Massachusetts 02116
Tel: 617-236-2062 Fax: 617-236-4689 info@bosrealty.com
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