Sublet Application Form (Page 8 of 19) in pdf

Sublet Application Information [cont]

Page 4 of 5

Additional Information [cont]

Please answer the following: (if any of these questions are answered “YES”, please provide details in the space provided or attach additional pages if needed)

□ YES

□ NO

Do the applicants own any Real Property or Co-operative Apartments?

if yes list address(es):

Lender: _

Balance of Loan: _

Current Market Value

Are you now, or in the past five (5) years have you been, privy to any lawsuits or other legal actions?

□ YES

□ NO

please describe:

□ YES

□ NO

Has the applicant(s) and/or occupant(s) ever been convicted of a felony?

please describe:

□ YES

□ NO

Are there any outstanding judgments against you?

please describe:

□ YES

□ NO

Is either the Applicant or Co-Applicant obliged to pay Alimony, Child Support, or Separate Maintenance?

please describe:

□ YES

□ NO

Is either the Applicant or Co-Applicant party in a lawsuit?

please describe:

□ YES

□ NO

Do you plan to keep any pets in this apartment?

please describe (species/breed/weight/age/etc):

Do you plan to play any musical instruments in this apartment?

□ YES

□ NO

please describe:

Representations / Authorizations

The undersigned applicant(s) understand(s ) that the consent of the co-operative board is required under the terms of the proprietary lease to the proposed sublet thereof and that the board

of direc tors will rely on the information f urnished above. The undersigned applicant(s) also agree(s) to meet in person with representatives of the corporation. Applicant(s) understand(s)

that the corporation reserves the right to request further information from the Applicant(s). The co-operative corporation, its officers, agents , and board of directors shall have no liability

with respec t to any matter or concerning any act of the shareholder in connectio n with any contact contemplated herein.

This applicatio n is submitted on behalf of the current shareholder(s) listed on this application and are to whom the co-operative corporation will respond. The applicant(s ) understand(s) that

he has no contractual or other relations hip with the co-operative corporation and any claims are limited solely to the shareholder.

The shareholder(s) and applicant(s) repres ent to the co-operative corporation, its bo ard of directors, officers, and agents that the applicant(s) are subleasing the premises for the purpose of

occupying same as a principal residence. The applicant(s) represent(s) that he will not allow any person or persons to occupy the premises except in accordance with the provisions of the

proprietary lease, by-laws, and rules and regulations of the co-operative corporation as same may be amended fro m time to time. The applicants) further represent(s) that the premises will

be occupied only by those persons listed o n this application. Said representations will survive the entire lease period and any subsequent lease periods.

All the representations and statements made by the shareholder(s) and applicant(s) are made with full knowledge that they will be relied upon by the co-operative corporation, its board of

direc tors, officers, and agents in connection with the applicatio n of the shareholder(s) and applicant(s) represent(s) that they are familiar with the proprietary lease, the by-laws , and rules

and regulations of the co-operative corporation, as some have been amended and will comply with all the provisions thereof. The co-operative corporation, its board of directors, officers,

and agents may rely upon this representation.

Applicant’s Signature

Date:

Co-Applicant’s Signature

Date:

Shareholder Signature

Date:

Shareholder Signature

Date:

The undersigned authorizes the co-operative corporation or its agents to retain a credit reporting agency. This agency may obtain, prepare and furnis h credit reports on my/our charac ter,

general reputatio n, personal characteristic s, and mode of living. (The above complies with Sec tion 606 of the Fair Credit Reporting Act.)

Applicant’s Signature

Date:

Co-Applicant’s Signature

Date: