Fill and Sign the Disclosed by You Herein is Material to the Potential Lessors Decision with Respect to 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 [ ]NoHome 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 2Are 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: __________________________________