570 Yonkers Avenue, 2nd Floor | Yonkers, New York 10704 | Telephone: (914) 965-1011 | Fax: (914) 965-0019 | Email:jdibbini@dibbinilaw.com

RESOURCES

Read Jim's Newsletters

Today is Sunday, February 5, 2012

NONPAYMENT INTAKE SHEET

MANAGEMENT/CLIENT INFORMATION:

Client Name*			Work Phone
Business Address1			Cell Phone
Business Address2			E-mail*
City			Fax
State			Prefer Hearing Status/Billing via
ZipCode

LANDLORD INFORMATION:

Landlord Name			Work Phone
Business Address1			Cell Phone
Business Address2			E-mail
City			Fax
State			Officer/Member Name
ZipCode			Title

BUILDING INFORMATION:

Type
If Other, Specify
Name of Registered Agent
Address Line 1
Address Line 2
City
State
ZipCode
Multiple Dwelling Registration (MDR) # (Required if premises contains 3 or more apartments)

TENANT INFORMATION:

Tenant Name	Other Occupants /Subtenants
Address1	Residential?	YES NO
Address2	If yes, is apartment legal	YES NO
City	Commercial	YES NO
State	If commercial describe type:
ZipCode	Additional Address for Service:
	Rent Stabilization /DHCR #:
LEASE INFORMATION:
Type::
*If Rent Stabilized or Other, please specify:
Section 8? YES NO If yes, specify type:
Lease Dates: From to
Current Lease Renewal: From to
Monthly Rent: Tenant’s Portion:
Amount Subsidized by Section 8: DSS:
Total Amount Due: Thru:
Rent Due on: 1st 15th Other
3 Day Rent Demand Served: YES NO If yes, when
Repairs needed to Apt: YES NO
Ever accepted DSS payments for this tenant in the past: YES NO
Specify grounds for proceeding (including dates and times of objectionable conduct, if applicable):

(Use additional paper if necessary to itemize all the specific grounds for termination of tenancy.)
* Rent Stabilized Apartments in NYC, please specify type:
1 It was subject to Rent Stabilization Law (RSL) on 6/30/74;
2. It became subject to RSL on 7/1/74. It had been subject to RSL on 6/30/71, but was destabilized prior to 7/1/74, because of a vacancy which occurred between 7/1/71 and 6/30/74;
3. It became subject to RSL on 7/1/74. It had been subject to the City Rent Law (rent control) on 6/30/71, but was decontrolled prior to 7/1/74, because of a vacancy which occurred between 7/1/71 and 6/30/74;
4. Built after 7/1/74 with J51 or 421A Tax Abatement.

Home |

About Us |

FAQs |

Testimonials |

Disclaimer |

Clients' Rights |

Site Map