Eviction Information Form

EVICTION INFORMATION FORM

Date:____, 201

Owner Information

1. Property Owner’s Full Legal Name: ______

2. Management Company’s Name: ______

3. Contact Person: ______

4. Billing Address: ______, ______, ______

Street Address City State Zip Code

Telephone No: ______Email Address: ______@______

Service

Do you want me to post if I am unable to obtain personal service? Yes ______No ______

posting service = possession ONLY / personal service = money judgment and possession

Tenant Information

5. Address of Rented Premises: ______, ______, ______, ______

Street Address Apartment # City State Zip Code

6. Tenant’s Name: ______S.S.#______Date of Birth ______

(required if in Platte County) (required if in Platte County)

Co-Tenant’s Name: ______S.S.#______Date of Birth ______

(required if in Platte County) (required if in Platte County)

7. Are there any unknown persons living in the Premises (John Doe / Jane Doe)? Yes ______No ______

Amounts Owed by Tenant(s)

8. What is the monthly amount of rent / fair market rental value? $_____.___

9. RENT: The Tenant(s) owe:

$ ______rent for the month of ______, 201_

Total rent owed: $ ______

10. LATE CHARGES: The Tenant(s) owe:

$ ______late charges for the month of ______, 201_

Total late charges owed: $ ______

11. DAMAGES AND/OR UTILITIES: (Please Specify) ______

______

Total damages owed: $ ______

12. TOTAL AMOUNT OWED: $ ______[Questions 9 -11]

Documents Needed

13. Do you have a signed Lease Agreement? Yes ______No ______

a. If yes, please attach a copy to this Eviction Information Form.

14. Do you have an updated Payment Ledger? Yes ______No ______

a. If yes, please attach a copy to this Eviction Information Form.

b. Your Payment Ledger MUST match the amounts requested above.

15. Were any notices sent to the tenant? Yes ______No ______

a. If yes, please attach a copy to this Eviction Information Form.

16. Have you filed a police report against the Tenant? Yes ______No ______

a. If yes, please attach a copy to this Eviction Information Form.

Collection Information

17. If we obtain a judgment, do you want us to collect the money for you? Yes ______No ______

*If you answered “Yes” to question 17, please continue to page 2.

18. EMPLOYMENT INFORMATION:

a. Tenant’s Name: ______

a. Employer’s Name: ______

b. Employer’s Address: ______, ______, ______

Street Address City State Zip Code

a. Co-Tenant Name: ______

b. Employer’s Name: ______

c. Employer’s Address: ______, ______, ______

Street Address City State Zip Code

19. BANK ACCOUNT INFORMATION:

a. Tenant’s Name: ______

b. Name of Tenant’s Bank: ______

c. Bank Address: ______, ______, ______

Street Address City State Zip Code

a. Co-Tenant’s Name: ______

b. Name of Co-Tenant’s Bank: ______

c. Bank Address: ______, ______, ______

Street Address City State Zip Code

Documents Needed

20. Do you have a Rental Application? Yes ______No ______

a. If yes, please attach a copy to this Eviction Information Form.

b. The information contained in the Application may help us find additional assets.

Final Questions

If I obtain a money judgment, and the above information is outdated, do you want me to search for new employment information and bank account information? Yes ______No ______

*Attention: There are additional costs involved in running a skip trace (up to $50.00).

I, the undersigned, am authorized to enter into this agreement on behalf of the above-named property. I agree to have The Law Offices of Anderson & Associates litigate this matter in the appropriate Missouri or Kansas court. I also agree to pay for the services and costs within 30 days of invoicing, regardless of a third party obligation to indemnify me as a property manager.

______

Signature

______

Printed Name

Please let us know how you heard about Our Company! ______

Eviction Information Form