Application By Tenant To Deposit Rent With The Clerk Form

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SHAKER HEIGHTS MUNICIPAL COURT

CUYAHOGA COUNTY, OHIO

APPLICATION BY TENANT TO DEPOSIT RENT WITH THE CLERK

No.

___________________

TO THE CLERK OF COURTS

NAME AND ADDRESS OF TENANT:

NAME AND ADDRESS OF LANDLORD OR AGENT

_______________________________________

____________________________________

_______________________________________

____________________________________

(Street No & Apt. No.)

(Street No. & Apt. No.)

_______________________________________

____________________________________

(City, State & Zip)

In accordance with R.C.§ 5321.07, paragraph (1), I hereby make application to deposit all rent that is due and hereafter becomes due

to landlord, with the Clerk of the captioned Court.

Date_______________________

Signed:_______________________________

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

INFORMATION IN SUPPORT OF APPLICATION:

The undersigned says the following facts are true to the best of his knowledge:

Notice was given in writing to landlord as prescribed in R.C.§ 5321.07, paragraph (A). (Copy of this notice attached

hereto.)

Service of the notice was made on landlord as follows: ________________________ _________________

(manner)

(date)

Payment of my rent due under the rental agreement is current.

My rent is due on ______________________ in the amount of $_______________________

(periodic payment date)

(monthly amount due)

Landlord ( did / did not ) supply me with notice in writing that he/she was party to any rental agreement which