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f:\admin\comlseapp.doc application for commercial lease property name: proposal's size:


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F:\ADMIN\ FOR COMMERCIAL LEASEPROPERTY NAME: PROPOSAL'S SIZE: APPLICANT''S NAME: TERM: LEASING AGENT(S): AVG. RATE: SF FINISH OUT: /SFYears in business ; as a [__] Individual[__] Corporation [__] Partnership [__] Other APPLICANT INFORMATIONApplicant's Full Name: Tax or SSN: Present Street Address: Suite: City: State: Zip: Telephone No.: Project Name: Tenant for How Long? Move Out Date: Landlord's Company Name: Contact: Phone: Property Management Company Name: Contact: Assumed Name/DBA: Type of Business: As applicable, for all officers or partners of Applicant, list below:Officer's or Partner's Names Title Address City State Phone 1. ________________________________________ ________________________________________ ___________2. ________________________________________ ________________________________________ ___________3. ________________________________________ ________________________________________ ___________Applicant's Previous Street Address: Suite: City: State: Zip; Telephone No.: Project Name: Tenant for how long: Move out Date: Landlord's Company Name: Contact: Phone: Contact: Phone: BUSINESS BANK/SAVINGS ACCOUNT REFERENCESBank/BranchBank Officer/PhoneCity/StateAccount Type & Number1. 2. 3. MAJOR NON-BANK CREDIT REFERENCESName of CreditorAddressCity/StatePhoneContract1. 2. 3. F:\ADMIN\ applicant (under the above name or any other name) or any officer, partner or affiliate of Applicant a rental/lease agreement?[ ] No[ ] Yes Explain: sued for nonpayment of rent:[ ] No[ ] Yes Explain: sued for damages to rental property [ ] No [ ] Yes Explain: bankruptcy:[ ] No[ ] Yes Explain: evicted:[ ] No[ ] Yes Explain: Is Applicant or any above officer(s) or [ ] No[ ] Yes Explain: Partner(s) involved in any litigation? APPLICANT'S SIGNED AND DATED FINANCIAL INFORMATIONPlease attach the following[ ] Current Balance Sheet[ ] Cash Flow Statement[ ] Income Statement[ ] Business PlanComments: The undersigned Applicant hereby declares that the representations of fact contained in the foregoing applicationare true and correct. If any such representation is false, any lease hereinafter entered into between Landlord andApplicant will have been made in reliance upon such representation and may, at the option of the Landlord, beterminated at any time. Applicant authorized The Kucera Company to verify the above references andrepresentations, including but not limited to, the use of credit information of Applicant: Date: Date: Date: Prepared by: Date: Reviewed by: Date:

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