Eviction Intake Form Personal InformationFull Name *Has any other attorney represented you in this matter? *YesNoName Of Prior AttorneyAddress Of Prior AttorneyStreet AddressApartment, suite, etcCityState/ProvinceZIP / Postal CodeTenant InformationTenant Name *Address Of Unit *Apartment, suite, etcCity *State/Province *ZIP / Postal Code *Are You A Corporation, LLC, Or Other Formal Entity?YesNoRegsitered Agent Of You Company *Registered Agent Street Address *Apartment, suite, etc *City *State/Province *ZIP / Postal Code *Registered Agent Telephone *Has The Tenant Retained An Attorney?YesNoName Of The Tenant's AttorneyAddress Of Tenant's AttorneyApartment, suite, etcCityState/ProvinceZIP / Postal CodePhone Number Of Tenant's AttorneyHow Many People Are On The Lease? *Name Of First Person On Lease *Age Of First Person On Lease *Name Of Second Person On Lease *Age Of Second Person On Lease *Name Of Third Person On Lease *Age Of Third Person On Lease *Name Of Fourth Person On Lease *Age Of Fourth Person On Lease *Name Of Fifth Person On The Lease *Age Of Fifth Person On The Lease *Lease InformationIs The Lease Written Or Oral? *WrittenOralPlease Upload A Copy Of The LeaseChoose FileNo file chosenDelete uploaded fileWhat Is Rented? *How & To Whom Is Rent Paid? *Are Utilities Included In The Rent? *YesNoWhat Are The Parking Provisions? *Are There Any Pet Agreements? *YesNoWho Is Responsible For Maintenance? *TenantLandlordHave There Been Maintenance Disputes In The Past? *YesNoPlease Explain *Is This A Contract For A Deed? *YesNoIs Federal Housing Assistance Involved? (ie Section 8) *YesNoName And Address Of Government AgencyHas The Property Been Inspected By A Municipal Or County Inspector? *YesNoDescribe When The Property Was Inspected And By WhomEviction InformationIs Rent Current? *YesNoPelase State How Much Rent Is Due And Your Basis For This Number? *Has The Lease Expired *YesNoHas A Written Notice Of Eviction Been Served? *YesNoHow, when, to whom was notice served? *Was The Notice Posted Or Served?PostedServedWhen And Where Was Notice Posted?Has A Court Case Been Filed? *YesNoIs A Court Date Set? If So, Please Provide The Date, Time, And County *Has A Court Order Been Entered?YesNoDoes The Tenant Have The Ability To Cure Lease Defaults?YesNoPlease Attach All Relevant DocumentsChoose FileNo file chosenDelete uploaded fileMISCELLANEOUS Send MessageSave as DraftPlease do not fill in this field.
