Fill and Sign the Case Type of Case Court in Which Pending Your Involvement in the Case the Nature and Amount of Relief Form

Application for Sub-lease, page 1 APPLICATION FOR SUB-LEASE List names of all current contractual Tenants for Leased Premises: Address/identification of Leased Premises proposed for sub-lease: Potential Sub-Lessees to answer the following questions and sign below [use a separate Application for each potential sub-lessee intending to sign sub-lease]: Name: [first]_________________ [middle]________________ [last]__________________ S.S.#: __________________________ Date of Birth: ___________________________ Marital Status: ____________Spouse’s Name: _________________________________ Children: _______________________________________________________________ Who other than yourself will dwell in the sub-leased premises: ___________________________________________________________________________________________ Your current address: _____________________________________________________ How long at this address: ____________ Are you a U.S. citizen: [ ]Yes [ ]No Home Phone: ________________________ Work Phone: ________________________ Driver's License Number: _________________________ State: ____________________ Place of Employment: _____________________________________________________ Employer’s Mailing Address: _______________________________________________ Your Supervisor: _________________________ Your Occupation: ________________________ Your Job Title: ___________________ Work Hours: ____________________________ Pay Dates: _______________________ Monthly Take Home Pay: __________________ How long at this job: ______________ Other sources of income and amounts: ________________________________________ Do you intend to reside here indefinitely? If not, for how long? ____________________ Have you ever filed Bankruptcy? [ ]Yes [ ]No - If Yes, where and when, and who was your attorney? ______________________________________________________________________________________ Are you currently a party to any lawsuit pending in court? [ ]Yes [ ]No - If Yes, give name and number of case, type of case, court in which pending, your involvement in the case, the nature and amount of relief sought by all parties, and the name of your attorney:____________________________________________ ________________________________________________________________________ ________________________________________________________________________ Application for Sub-lease, page 2 Are you subject to a judgment by any court? [ ]Yes [ ]No - If Yes, describe judgment: ________________________________________________________________________ List Four (3) Friends or Relatives as references: Name: __________________________ Address: _____________________________ Phone: __________ Name: __________________________ Address: _____________________________ Phone: __________ Name: __________________________ Address: _____________________________ Phone: __________ By your signature hereon, you agree that the information disclosed by you herein is true, complete and accurate to the best of your knowledge, and you agree that the information disclosed by you herein is material to the potential Lessor’s decision with respect to granting or denying your application for sub-lease. Signed: ______________________________________ Date: ____________________ Print Name: __________________________________