Lease Application If you are human, leave this field blank. For Property Located At * Tenant Information Legal Business Name * Doing Business As (DBA) Business Phone Number * Business Fax Number Website Address Date Business Established * Specific Use Of Premises * Business Ownership * Proprietorship Limited Liability Company (LLC) Corporation Partnership Date of Incorporation * State of Incorporation * Owner(s) or Officer/Partner Information First Name * Last Name * Title * Home Phone Number Cell Phone Number Email Address * Home Address * Home Address Home Address Home Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Social Security Number * Driver's License & State * Date Of Birth * Add Remove Current Bussiness Address Lease Currently Leasing Address * Address Address Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Landlord Name * Landlord Phone Number * Monthly Lease Amount * Term of Lease * Previous Business Address Not Applicable Address * Address Address Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Landlord Name * Landlord Phone Number * Monthly Lease Amount * Term of Lease * Business Declarations HAS THE BUSINESS, ITS OFFICERS, PARTNERS, OR OWNER EVER BEEN DELINQUENT IN PAYMENT OF ANY FINANCIAL OBLIGATION OR FILED FOR BANKRUPTCY? * Yes No If Yes, Explain: HAS THIS BUSINESS, ITS OFFICERS, PARTNERS, OR OWNER EVER BEEN A DEFENDANT IN AN UNLAWFUL DETAINER AND/OR BREACH OF CONTRACT LAWSUIT? * Yes No If Yes, Explain: * Authorization * I/We hereby authorize Pacific West Business Properties, Inc. to verify all information and to check Lessee’s credit and/or financial information on this application by contacting the sources listed herein or any other sources available. Additionally, in the event of a default during Lessee’s tenancy, Pacific West Business Properties, Inc. is authorized to check Lessee’s credit. I/We understand that information that does not verify, or cannot be verified, may result in this application not being approved.
