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YOUR INFORMATION

I want to start a:

Holdover NonPayment I’m not sure

I prefer to be contacted by:

Phone Email

Name: Address: Email: Phone: (Ex: 555-555-5555) Fax: PROPERTY INFORMATION Tenant Name(s): 1st: 2nd: 3rd: Sub-Tenant: (please list all adults currently residing at the premises including adult children of legal tenants) Tenant Address:(incl apt. number) Landlord/Owner of Premises as it Appears on the Deed What day of the month is rent due? Does the tenant have a lease? When does the lease expire? When is the last time you accepted rent from this tenant? How many apartments are in your building? MDR# Name & Address of Managing Agent

Is your building (If you are not sure whether or not the apartment is rent stabilized or rent controlled, please email or call the office.)

Stabilized Controlled Neither Store or Office

Do you receive payments from SECTION 8? What is the reason you would like to remove this tenant? Total Amount of Rent Due (This information is only necessary for non-payment proceedings) BREAKDOWN OF AMOUNT DUE

Month

Amount

Todays Date Type the code:*

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(718) 460-5421

Start An Eviction Proceeding