START AN EVICTION

Please fill out the following information and press the SUBMIT button: If you have any problems completing or submitting this form, please call (954) 229-1008. Please note that the fields with* are required fields. About the Landlord: (Landlord = legal property owner) Landlord Name (First and Last or Name of Business Entity)*   Your Spouse's name (First and Last) (Required if the property is owned by you and your spouse) Landlord Mailing Address*  City*   State*        Zip Code*    Landlord Phone Number *    Landlord E-mail*       ***You will receive updates on your case via email. About the Rented Premises: Address of the Rented Premises*  Apartment Number County*   City    State  Florida   Zip Code *  About the Tenant(s) Please provide the name(s) and phone number(s) of the tenant(s) residing at this address. Tenant 1* : Tenant 1 (PROVIDE FULL NAME: First Middle Last ) Tenant 2: Tenant 2 (PROVIDE FULL NAME: First Middle Last)   Is this a month-to-month lease agreement?*  No Yes <\SELECT> Is there a written lease agreement?*  Yes No <\SELECT> Pleaseemail (evictions@reillyroche.com ), fax (954-229-1006) or mail (Reilly Roche LLP 1350 NE 56th Street, Suite 140 Fort Lauderdale, FL 33334) a copy of the lease agreement as it needs to be attached to the Eviction Complaint. Has there been a sublease?*  No Yes <\SELECT>   If so, please provide details regarding sublease: Are you currently holding a deposit on the tenant(s)?*    Yes No <\SELECT> If yes, please state how much.  Did you serve the tenant with a three-day notice?*  Yes No <\SELECT> If you did serve the tenant with a three-day notice, please email (evictions@reillyroche.com), fax (954-229-1006) or mail (Reilly Roche LLP 1350 NE 56th Street, Suite 140 Fort Lauderdale, FL 33334) a copy of it along with proof of service as it needs to be attached to the Eviction Complaint. How much is the monthly rent?*  When was rent due?*  How much is currently past due?*   I hereby acknwoledge that.I HAVE READ AND UNDERSTAND  REILLY ROCHE LLP'S  ATTORNEY CLIENT AGREEMENT  AND AGREE TO BE BOUND BY ALL OF ITS TERMS and that in the event the case is contested or the tenant files a counter claim, the attorneys' fees and costs may increase *SIGNATURE (please sign by entering your full name in the space provided)   If you have any problems completing or submitting this form, please call (954) 229-1008. Please note that the fields with* are required fields.