| PLEASE ANSWER THE FOLLOWING QUESTIONS: |
| Plaintiff/Landlord Name: |
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| Address (Plaintiff): |
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| City (Plaintiff): |
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| State (Plaintiff): |
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| Zip Code (Plaintiff): |
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| Phone (daytime): |
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| Phone (evening): |
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| Email: |
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| THE RESIDENCE IN QUESTION - The Complete Address of the Rental Property. |
| Rental Location Address: |
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| City: |
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| State: |
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| Zip Code: |
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| THE FULL NAMES OF THE TENANTS - List the names of the individuals CURRENTLY living in the residence/property. |
| Tenant # 1: |
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| Tenant # 2: |
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| Tenant # 3: |
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| Tenant # 4: |
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| Tenants Phone Number: |
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| THE DATE OF THE ORIGINAL MOVE IN AND RENTAL AMOUNT- Be specific as to the exact date the CURRENT tenants took legal possession of the property and the amount of rent the agreement requires them to pay. |
| Move In Date: |
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| What was the amount of monthly rent required at move
in?: |
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| Has the rental amount changed since the current tenants took possession?: |
Yes
No |
| If yes above, what is the new monthly rental amount required?: |
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| Comment on change in rental amount and the DATE rental amount changed: | |
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| HOW LATE IS THE RENT - List each month including year for which the rent is not paid or only partially paid. |
| Comment on late rent: | |
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| DO YOU SUSPECT PROPERTY DAMAGE? - Choose the amount in dollars of the amount of property damage you suspect. |
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HAS A THREE DAY OR 30 DAY NOTICE BEEN SERVED? - If so, you MUST fax or email a copy to us. ALSO check any other notices that may have been served.
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| Additional comment on notice served: | |
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| HOW WAS THE NOTICE TO PAY RENT OR QUIT (3 day) OR 30 DAY NOTICE SERVED? - Choose one and comment. |
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| Person Served: |
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| Additional comments on manner of service of notice AND date served: | |
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| Complete Section Below Only If Notice Was Mailed |
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| IS THERE A WRITTEN RENTAL APPLICATION? - If so, you MUST fax or email a copy to us. |
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Yes
No | |
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| WHAT DAY OF THE MONTH WAS THE RENT DUE ACCORDING TO YOUR RENTAL AGREEMENT? - Choose one and/or Comment. |
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| DO YOU HAVE SOCIAL SECURITY NUMBERS ON TENANTS? If so, list below. |
| Social security numbers: |
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DESCRIBE HOW THE TENANTS DEFAULTED IN THEIR RENTAL/LEASE AGREEMENT WITH YOU - Be specific as to the violations to the rental agreement that you will allege in your complaint. |
| Tenant(s) defaulted by: | |
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| DESCRIPTION OF TENANT(S) - Please be very specific as to the Age, Weight, Height, Complexion, Race, Nationality, Demeanor and any other Characteristics that will help identify the Tenant(s). |
| Description of tenants: | |
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| DO YOU HAVE REASON TO BELIEVE THAT THERE ARE SUB-TENANTS LIVING ON THE PREMISES? - Choose yes or no. If Yes, Comment further. |
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Yes
No | |
| Sub-tenants?: | |
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| DO YOU KNOW WHERE TENANTS ARE CURRENTLY EMPLOYED? Please comment. |
| Tenant(s) employment: |
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| HOW WAS RENT USUALLY PAID - Comment on whether rent was paid by check, money order or cash. |
| Rent paid manner: | |
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| HOW MUCH RENT WAS DUE AT THE SERVICE OF THE THREE DAY NOTICE ? - |
| Add all rent due as of 3 day notice date and put total here. |
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| Total rent due at service of notice: |
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| Additional comments: | |
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| THIS INFORMATION IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE. |
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