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8689 SIERRA AVE., STE. B FONTANA, CA 92335

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CLIENT INFORMATION

Is there a particular office you prefer to work with?

Pease select the Associate you would prefer to handle your case:

Full Name of Contact, Property Manager, or Master Tenant:

Are you one of the following:

Full Name of Owner:

Billing Address:

Street Address

Street Address 2

City

State / Province / Region

Postal / Zip Code

Would you like to use the billing address for all court correspondence?

Cell Phone

Fax Number

Email Address

Other Phone

Do you receive any government assitance? Check all that apply.

Medi-Cal Food Stamps SSI SSP County Relief or General Assistance IHSS Cal Works or Tribal T ANF CAPI Other

Please provide proof of government assistance:

Property Address

Street Address

Street Address 2

City

State / Province / Region

Postal / Zip Code

Property Access Code:

Tenant Information

*Please provide as much information as possible, it is not detrimental if you do not have part or any information regarding the tenant. Make sure you list only adults no children (18+ only).*

Full Name: (If unknown: List as Jane or John Doe)

Date of Birth or Approximate Age:

Home Phone:

Other Phone:

Driver License or ID#:

Social Security #:

Height

Weight

Eye Color:

Hair Color:

Ethnicity:

Gender:

Full Name: (If unknown: List as Jane or John Doe)

Date of Birth or Approximate Age:

Home Phone:

Other Phone:

Driver License or ID#:

Social Security #:

Height

Weight

Eye Color:

Hair Color:

Ethnicity:

Gender:

General Questions

1. Please provide the best estimated time to serve your Tenants?

2. What type of agreement is in place?

3. The agreement is a: ( If agreement is verbal automatically select Month to Month)

3. a) If a lease is in place when does it expire?

3. b) If written agreement, do you have original agreement?

3. c) If there is a written agreement in place

4. Date of agreement or date opposing party moved into the property (if unsure give estimated date):

5. Monthly Rent:

6. Are there any children in the premises:

7. Are there any weapons in the property:

8. Are tenants behind on rent:

Rent Owed:

9. (No more than 6 months without proof) Note: Rent ONLY, do not include any other additional fees tenants owe

From Date:

To Date:

Rent Due $:

From Date:

To Date:

Rent Due $:

From Date:

To Date:

Rent Due $:

From Date:

To Date:

Rent Due $:

10. What is the reason you are evicting the tenant?

11. Have you served any notices?

12. If notice has been served

13. How did you hear about us

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Please read the following carefully sign and date by printing your name you are signing this document electronically.

I declare under the penalty of perjury under the laws of the state of California that the foregoing is true and correct. I also Understand that Legal Service Centers will prepare all legal documents at my direction. I understand there may be additional fees if the matter becomes contested, as well as additional filing fees, process service fees, or court runner fees. If any amendments , or additional documents are prepared there will be additional fees that will apply. I understand Legal Service Centers DOES NOT ISSUE REFUNDS.

By typing my name bellow I understand that that I am signing this document electronically.

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San Bernardino, CA

240 W. 5th St,
San Bernardino, CA 92401
(909) 271-1792

/

Give Us A Call

(909) 271-1123

/

Rialto, CA

202 N. Riverside Ave., Suite D, Rialto, CA 92376
(909) 271-1405

Why Choose Legal Service Centers

Our Interview With City of Fontana

Why Choose Legal Service Centers

Our Interview With City of Fontana

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CLIENT INFORMATION

Property Address

Tenant Information

General Questions

Rent Owed:

9. (No more than 6 months without proof) ***Note: Rent ONLY, do not include any other additional fees tenants owe***

Please read the following carefully sign and date by printing your name you are signing this document electronically.

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Do You Need Legal Help?

San Bernardino, CA

240 W. 5th St, San Bernardino, CA 92401(909) 271-1792

/

Give Us A Call

(909) 271-1123

/

Rialto, CA

202 N. Riverside Ave., Suite D, Rialto, CA 92376(909) 271-1405

Why Choose Legal Service Centers

Our Interview With City of Fontana

Why Choose Legal Service Centers

Our Interview With City of Fontana

9. (No more than 6 months without proof) Note: Rent ONLY, do not include any other additional fees tenants owe

240 W. 5th St,
San Bernardino, CA 92401
(909) 271-1792

202 N. Riverside Ave., Suite D, Rialto, CA 92376
(909) 271-1405