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COVID-19 Tenant Relief
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COVID-19 Tenant Relief
Please enable JavaScript in your browser to complete this form.
-
Step
1
of 4
Important!
Instructions:
Please fill-out this request form in full and submit it with any necessary attachments.
To complete this form you will need the following:
- Basic Lease Information
- 2019 Financial Statements (Income Statement, Balance Sheet, and Statement of Cash Flows - Parent Company)
- Month-end financial statements (P&L), January 2020 - Current 2020.
- Any stimulus-related denial letter(s) issued to Tenant
Section 1
Name of individual filling out this form
*
First
Last
Date / Time
*
Date
Time
Tenant's Name (Signing entity or person(s) on the lease)
*
Contact Name
*
First
Last
Contact Phone Number
*
Contact Email
*
Email
Confirm Email
Tenant's Leased Property Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
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
Zip Code
Is the Tenant a subsidiary entity?
*
Yes
No
Name of parent company
*
Next
Section 2
Please select any State, Federal, or personal relief you have applied for
*
PPP (Paycheck Protection Program)
CARES ACT
SBA 7A Disaster Relief
Personal Bank Loan
Other
None
Have you or your ownership group been Denied any of these loam programs?
*
No
Yes
Unsure, It is still being processed
What was the denial reason?
*
Please describe the relief or proposal your or your entity is requesting from the property owner.
*
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Next
Section 3
Other information required in addition to the Tenant Relief Intake Form to process Tenant's Relief Request
Please upload the following documents:
2019 Financial Statements (Income Statement, Balance Sheet and Statement of Cash Flows - Parent Company)
*
Click or drag a file to this area to upload.
Month-end financial statements (P&Ls), January 2020 - Current 2020.
*
Click or drag a file to this area to upload.
Any stimulus-related denial letter(s) issued to Tenant
Click or drag a file to this area to upload.
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Next
Financial Relief Request and Statement of Accuracy
As of the date listed above, and due to the on-going financial hardship attributed to the COVID-19 outbreak, the Tenant is requesting financial relief or assistance in some form from Landlord. This request is not an agreement, amendment to an existing constitute a tenant default. This information is being provided for discussion purposes only at this time.
Landlord will expeditiously work to review completed Tenant Relief Requests. Priority review will be provided to fully complete submissions, which may include the submission of any and all documents listed in Section III of the Tenant Relief - Intake Form. Further documentation may be requested by Landlord in conjunction with processing this request.
Do you agree to the following statement of accuracy?
*
Yes
No
Tenant acknowledges that the information provided with this request including financial statements and documents that may be submitted as attachments in conjunction with this request, are true and accurate to the best of Tenant's knowledge. If Tenant becomes aware that previously submitted documents or financial statements being used to evaluate the Tenant's circumstances are incorrect, Tenant will immediately notify Landlord (within 24 hours and prior to the signing of any and all agreements being contemplated by Tenant and Landlord) of the inaccuracy or inaccuracies and expeditiously work to correct them. Knowingly submitting inaccurate financial statements for financial gain is an act of fraud.
Signature
*
First
Last
By typing my name in the above box and submitting this form I agree that I am a authorized Signatory of the Tenant entity and have reviewed the Tenant Relief Request Form, the Financial Relief Request and Statement of Accuracy, and have reviewed the attachments listed above and, to the best of my knowledge, represent the information provided as accurate as of the date of this document.
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