84th Street Industrial, LLC

Located in Scottsdale, AZ

15820 N 84th St

Scottsdale, AZ 85260

Contact us for leasing information headline goes here

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First Name*

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Comments

Application for Lease

Property*

Location of Proposed Lease

Date

Agent

Full Legal Name of Applicant

Date of Birth

Applicant’s SSN#

Marital Status

Single

Married

Spouse’s Name

Spouse’s Date of Birth

Spouse’s SSN#

Home Address

Street Address City State ZIP Code

Home Phone

Legal Business Name

Business Type

Individual (Sole proprietorship)

Corporation*

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Limited Liability Corporation*

Doing Business As (dba)

Current Business Address

Street Address City State ZIP Code

Business Phone

Business email

*Federal Tax ID#

*State of Incorporation/Partnership/LLC

*Officers/Partners/Managers (names & titles)

Name

Title

Name

Title

Name

Title

Name

Title

Name & Title of Person Signing Lease

Title

Type of Business

Intended Use of Premises

Would dangerous commodities, chemicals, hazardous materials, hazardous substances or hazardous waste (any fuels, including diesel fuel, gasoline, etc.) be treated, stored, generated or otherwise utilized on the Premises?

Yes

Explain

Current Landlord

Address

Street Address City State ZIP Code

Contact Name

Phone

Trade References

Name

Address

Street Address City State ZIP Code

Phone

Name

Address

Street Address City State ZIP Code

Phone

Name

Address

Street Address City State ZIP Code

Phone

Name

Address

Street Address City State ZIP Code

Phone

Bank References

Name

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Street Address City State ZIP Code

Phone

Contact Name

Account No.

Type of Account

Name

Address

Street Address City State ZIP Code

Phone

Contact Name

Account No.

Type of Account

Name

Address

Street Address City State ZIP Code

Phone

Contact Name

Account No.

Type of Account

Name

Address

Street Address City State ZIP Code

Phone

Contact Name

Account No.

Type of Account

Personal Financial Statement

This form must be accompanied by a bank statement showing cash in bank and a copy of the trust deed to your property or other proof of ownership. If additional information is required, please provide a separate attachment.

Self

Name

Address

Street Address City State ZIP Code

Social Security #

Birth Date

Spouse

Name

Address

Street Address City State ZIP Code

Social Security #

Birth Date

The undersigned, for the purpose of procuring and establishing credit from time to time with you and to induce you to permit the undersigned to become indebted to you on notes, endorsements, guarantees, overdrafts or otherwise, furnishes the following (or in lieu thereof the attached) which is the most recent statement prepared by or for the undersigned as being a full, true and correct statement of the financial condition of the financial condition of the undersigned on the date indicated, and agrees to notify you immediately of the extent and character of any material change in said financial condition, and also agrees that if the undersigned, or any endorser or guarantor of any of the obligations of the undersigned, at any time fails in business or becomes insolvent, or commits an act of bankruptcy, or dies, or if a writ of attachment, garnishment, , execution or other legal process be issued against property of the undersigned or if any assessment for taxed against the undersigned, other than taxes on real property, is made by the federal or state government or any department thereof, or if any of the representations made below prove to be untrue, or if the undersigned falls to notify you of any material change as above agreed, or if such change occurs, or if the business, or any interest therein, of the undersigned is sold, then and in such case, all of the obligations of the undersigned to you or held by you shall immediately be due an d payable, without demand or notice. This statement shall be construed by you to be a continuing statement of the condition of the undersigned, and a new and original statement of all assets and liabilities upon each and every transaction in and by which the undersigned, hereafter becomes indebted to you, until the undersigned advises in writing to the contrary.

Assets

CASH IN CHECKING ACCOUNT(S)

CASH ON HAND: (CONFIDENTIAL)

CASH IN SAVINGS ACCOUNT(S)

STOCKS AND BONDS (SCHEDULE B)

NOTES RECEIVABLE-GOOD: (TO INCLUDE LOANS TO

CASH SURRENDER VALUE-LIFE INSURANCE

AUTO 1

AUTO 2

AUTO 3

REAL ESTATE (Schedule A)

OTHER ASSETS: (describe)

OTHER ASSETS: (amount)

TOTAL ASSETS

Annual Income

SALARY

SECURITIES INCOME

OTHER: (describe)

OTHER: (amount)

Total

Liabilities

NOTES PAYABLE TO

ACCOUNTS PAYABLE

TAXES PAYABLE

CONTRACTS PAYABLE: (TO WHOM)

REAL ESTATE INDEBTEDNESS (Schedule A)

BUSINESS INDEBTEDNESS: (To whom)

Other liabilities: (credit cards, etc.)

Other liabilities 1

Amount

Other liabilities 2

Amount

Other liabilities 3

Amount

Other liabilities 4

Amount

Other liabilities 5

Amount

TOTAL LIABILITIES

NET WORTH

ANNUAL EXPENDITURES: (EXCLUDING ORDINARY LIVING EXPENSES)

MORTGAGE/RENTAL

INSURANCE PREMIUMS

Taxes and House hold expense

TOTAL LIVING EXPENSES:

SCHEDULE A: REAL ESTATE

Location and type of

Title in Name of

Estimated Value

Amount Owing

To Whom Payable

Location and type of

Title in Name of

Estimated Value

Amount Owing

To Whom Payable

Location and type of

Title in Name of

Estimated Value

Amount Owing

To Whom Payable

Location and type of

Title in Name of

Estimated Value

Amount Owing

To Whom Payable

Location and type of

Title in Name of

Estimated Value

Amount Owing

To Whom Payable

SCHEDULE B: STOCKS AND BONDS

Number of Shares Amount of Bonds

Description

Current on Listed

Estimated Value on Unlisted

Number of Shares Amount of Bonds

Description

Current on Listed

Estimated Value on Unlisted

Number of Shares Amount of Bonds

Description

Current on Listed

Estimated Value on Unlisted

Number of Shares Amount of Bonds

Description

Current on Listed

Estimated Value on Unlisted

Number of Shares Amount of Bonds

Description

Current on Listed

Estimated Value on Unlisted

Are there any suits or judgments against you?

Any Pending?

Have you gone through bankruptcy or compromised a debt?

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Date

Print Name

Title

Signature

Date