July 17, 2019

Cohen Hurkin Case Intake Sheet

For Current Clients Only

Bill To:*
Billing Address:*
City, State Zip*
Landlord (On Lease)*
Tenant #2
Occupant #1
Occupant #2
Tenant Address*
Tenant Apt #*
Tenant Floor
City, State Zip*
Lease Type*
Rent Due On*
Rent Per Month*
Section 8 Portion
Building Rental Status*
If Decontrolled, Why?
Decontrolled Reason Other
Managing Agent*
Managing Agent Address*
  Note for Total Arears: Do not include legal fees, late fees, section 8, etc
Total Arrears*
Extra Charges
  Enter Monthly Arrears Breakdown
Monthly Arrears
Initial Action*

If nothing happens, you omitted required input.
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