Name:
E-mail:
Address:
City:
State/Province:
Country:
Postal Code:
Phone:
1) If not the Landlord, your Relationship to the Landlord.
Relationship:
2) Is the Lease with Tenant Oral or Written? (a copy will be requested once payment is received)
Type of Lease:
Oral
Written
3) Name of the Landlord exactly as indicated on the Lease.
Landlord Name:
4) Is the Landlord an individual or an entity?
Individual
Entity
5) List the names of all tenants as listed on the lease
6 a) Is the length of the lease specified?
Yes
No
6 b) If yes, please indicate the start and end date.
start
end
7) What is the amount of Rent?
8 a) How frequently is Rent Paid?
Weekly
Bi-weekly
Monthly
8 b) Other
9 a) When is rent due?
(for example: some lease due dates are the 15th of each month, some are the 7th etc)
1st Day of the Week
1st Day of the Month
9 b) When is rent due?
10) What is the Reason for Eviction? Please keep to a minimum.
11) If rent is past due, what is the amount of rent due? (Include rent only, do not include late fees; also, please make amount of rent due relative to rental periods along with a grand total? (example: May 1,000, June 1,000 and July 1,000 for a Total of 3,000)
12 a) Have you started the eviction process?
Yes
No
12 b) If so, what have you done?
13) What Damages (not including rent) do you claim are due from the Tenant? (an itemized account will be requested once payment is received)
14) Have you sent your Tenant any written documents?
15) Have you sent your Tenant a written 3-Day Notice for Failure to Pay Rent?
Yes
No
16) Have you sent your Tenant a written 7-Day Notice for non-compliance with the Lease?
Yes
No
17) Have you sent your Tenant a written notice terminating the lease?
Yes
No
18) Has the Tenant claimed that you breached the Lease in anyway?
Yes
No
19) Have you received any documents or written notices from the Tenant?
Yes
No
20) Has the Tenant claimed that you needed to make certain repairs to the Property?
Yes
No
21) Has the Tenant paid any rent into the Court Registry?
Yes
No
I don't know
22) Has the Tenant hired an Attorney?
Yes
No
I don't know
23) If the Tenant offers to pay past due rent, would you accept the rent and dismiss the suit?
Yes
No
24) Confirm that you understand that once the Eviction Process has begun, you cannot accept rent from the Tenant if you want to proceed with the Eviction.
I understand and agree
25) Confirm that you understand that additional attorney’s fees will be owed if a hearing, mediation or trial is required in your case.
I understand and agree
26) Confirm that you understand that your tenant has to be personally served for the damages claim to be enforced and that it may take longer than the eviction process for possession only.
I understand and agree
27) Confirm that you understand that a Sheriff’s fee may be required for a Writ of Possession if the Tenant fails to leave the property after a Final Judgment has been entered. The amount of the fee is determined by, and paid to, the County’s Sheriff’s Office.
I understand and agree
Additional Comments:
28) By submitting this information you hereby confirm that:
The person requesting this action for eviction is fully authorized to do so;
The landlord has full knowledge of this action for eviction; and
Both individuals grant this Firm the permission obtain, and enforce, a judgment of eviction and damages.