Fitzgerald Lease Application

8/9/2019 Fitzgerald Lease Application

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Cooper Square Realty, Inc.

6 East 43rd Street New York, NY 10017-4609

Phone: 212-634-8900 Fax: 212-634-3946

The Fitzgerald Condominium Lease Application

Dear Prospective Resident:

Thank you for your interest in The Fitzgerald Condominum!

Enclosed is your Lease Application. Please complete and forward the application, along with

the required documents, to Cooper Square Realty, Inc. 6 East 43rd Street, 14th Floor, New

York, NY for processing.

It is important that you urge your references to submit their letters of reference to you as soon a

possible, since your application cannot be processed until they are received.

If you have any questions regarding your application, please contact Cooper SquareRealty, Inc.'s Application Processor at (212) 634-8900.

Again, thank you for your interest in The Fitzgerald Condominum! We look forward tohearing from you.

Sincerely,

COOPER SQUARE REALTY, INC.

Transfer Department

02/20/07 01:13 PM


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Phone: 212-634-8900 Fax: 212-634-3946

The Fitzgerald Condominium Important Informationand Required Documents

The following is a list of the items you are required to submit for the board to review your application. Please be sure to provide all theinformation requested. Items missing will only delay the Managing Agents review and submission to the Board.

Important Information (Please read carefully before completing your application)

Please submit one (1) original of the completed application package. Incomplete packages will not be forwarded to the Board.THE APPLICANT INFORMATION AND FINANCIAL INFORMATION FORMS MUST BE TYPED OR PRINTED LEGIBLY WITH BLACKINK.

Cooper Square Realty realizes that this application contains sensitive personal information. We require the socialsecurity number for each applicant (and each other adult occupant of the apartment) on the Authorization toObtain Consumer Reports Form. This is the only place on the application requiring a social security number, butsocial security numbers may be contained in other documents that you are submitting (e.g. tax returns, contractsof sale). Before submitting these documents, please black out or otherwise obliterate the social security number

as Cooper Square Realty can not be responsible for the security of this information if it is included in thesedocuments.

A personal interview is required after application materials are submitted and reviewed.

Moving company must submit Certificate of Insurance (binder) evidencing $1,000,000.00 comprehensive

public liability, including $1,000,000.00 property damage liability and workers compensation and employees

liability covering all employees and sub-contractors. Certificates of insurance should evidence that the

Condominium Association, Cooper Square Realty and unit owner are named as additional insured. Must be

submitted to Ezra Bennett, Property Manager.

Complete the following enclosed forms and return:___ 1. Applicant Information for Lease- This form must be filled out in its entirety in order for your application to be considered for

review. All applicants and guarantors are required to complete Part 1___ 2. Fee Acknowledgement Form must be signed by all applicants and guarantors.___ 3. Financial Information- This form must be filled out in its entirety in order for your application to be considered for review. All

applicants and guarantors are required to complete Part 2.___ 4. Consumer Report Authorization- must include social security number, birth date and a US residence (no PO Boxes). Every

adult (over 18 years of age) occupant of the apartment must submit a consumer report authorization. ___ 5. Notice of Intention to Lease

___ 6. Move-in Rider

___ 7. Notification of Legal Mailing Address

___ 8. Window Guard Rider Form with complete address and correct boxes checked

___ 9. House Rules Acknowledgement

___ 10. Lease Agreement with Rider must be REBNY

Each applicant will be required to contribute the following documents: (Documents will not be returned)___ 1. Employment Verification Letter (stating annual salary, position held, length of employment). If you are self employed, please

submit a letter from your CPA or accountant stating your income.___ 2. Federal Tax Returns (past 2 years)- including your signature and all schedules. After April 15th, you must include the most

recent year's taxes OR a copy of your extension filing and the two most recent year's tax returns. ___ 3. W-2 forms

___ 4. Landlord Reference Letter-must state length of residence and payment history. ___ 5. Two (2) Financial Reference Letters ___ 6. Two (2) Personal Reference Letters

Additional Information (Enclosed for your information. Do not submit with application)1. Local Law #1 Lead Based Paint Disclosure Booklet2. House Rules and Regulations3. "Protect Your Family from Lead in Your Home" Pamphlet


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Phone: 212-634-8900 Fax: 212-634-3946

The Fitzgerald Condominium Lease Fees

The following is information about the board application process and a schedule of fees. Please review this information before

completing your application.

Schedule of Fees - Due at submission:

Payable by Applicant1. $700.00 Application Processing Fee (non-refundable) payable to Cooper Square Realty, Inc. Includes one credit

report per application. Renewing or extending a current lease fee is $000.

2. $75.00 Consumer Report Fee (per ADDITIONAL report) (non-refundable) payable to Cooper Square Realty, Inc. Allapplicants, guarantors, and adult occupants must have a consumer report. This building includes ONE creditreport per application. Additional applicants, guarantors, and adult occupants must submit this fee.

3. $112.50 Document Production Fee (non-refundable) payable to Cooper Square Realty, Inc.

4. $200.00 Move-In Fee (Due at application submission) (non-refundable) payable to The Fitzgerald Condominum.

5. $1,000.00 Move-In Deposit (Due at application submission) (refundable) payable to The Fitzgerald Condominum.Deposit will be refunded after moving inspection by managing agent if no damage has occurred during move.

Payable by Shareholder(s)1. $200.00 Move-Out Fee (Due at application submission) (non-refundable) payable to The Fitzgerald Condominum.

2. $1,000.00 Move-Out Deposit (Due at application submission) (refundable) payable to The Fitzgerald Condominum.Deposit will be refunded after moving inspection by managing agent if no damage has occurred during move.

Fees AcknowledgementI (we) hereby acknowledge that all fees paid pursuant to this lease application are non-refundable, unless otherwise noted, andhereby authorize you or your agents to obtain a credit report and related information and contact any references or employers listedherein

XApplicant Date

XCo-Applicant (if any) Date


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Phone: 212-634-8900 Fax: 212-634-3946

Part 1 - Applicant Information for Lease

Applicant InformationToday's date: Requested move-in date:

Building name: The Fitzgerald Condominium Apartment number:Unit address:Lease term: to

Length of lease: Annual rent:Monthly rent:Security:Special conditions (if any):Managing agent: Cooper Square Realty, Inc. Phone: 212-634-8900Inc. Agent address: 6 E 43

rdStreet Contact person: Application Processor

Unit Owner(s) Shareholder(s)Name(s):

Current address: Phone:E-mail:

Mailing address if lease approved (if different)

Reason for Sublease:

Lessors Broker: Phone:E-mail:

Applicant(s)Applicant:

Office phone: Home phone:E-mail:

Co-Applicant:Office phone: Home phone:E-mail:

Lessees Broker: Phone:

E-mail:

Housing HistoryCurrent landlord: Phone:Address: Rent:

Dates of occupancy:Reason for moving:

Previous landlord: Phone:Address: Rent:

Dates of occupancy:Reason for moving:


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Phone: 212-634-8900 Fax: 212-634-3946

Applicant(s) Personal InformationApplicant Co-Applicant

Applicant name:Address:

Dates of residence:US Citizenship: Yes No Yes NoEmployment Status: Full-time Part-time Unemployed

Retired StudentFull-time Part-time UnemployedRetired Student

Nature of business:Current employer:Employers Address:

Are you self employed: Yes No Yes NoDates of employment:Years in this line of work:Title or position:Supervisors name:Business phone:

Prior employer:Prior title:Prior employers address:

Prior dates of employment:

Prior employers phone:Estimated income this year:

Actual income last year:Educational background:Schools attended:Dates attended:

Will occupancy be: Full-time Part-time

List the names of ALL proposed occupants (including applicants), and their relationship to applicant(s):

List the names of anyone in the building known to the applicant(s):

Are any pets to be maintained in the apartment? Yes No (Note: If yes, indicate number and kind.)

Has the applicant(s) and/or any occupant(s) ever been convicted of a felony? Yes No (Note: If yes, please explain.)


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Phone: 212-634-8900 Fax: 212-634-3946

Applicant Co-ApplicantPersonal References1. Name:

Address:

Phone:

2. Name:Address:

Phone:

3. Name:Address:

Phone:

Professional/Financial References1. Name:

Address:

Phone:

2. Name:Address:

Phone:

3. Name:Address:

Phone:

Bank & Credit ReferencesBank Name:Bank Address:Account number: Checking Savings LoanBank Name:Bank Address:Account number: Checking Savings Loan

I agree, as a condition of processing this application, that Cooper Square Realty, Inc. (Cooper Square Realty, Inc.) and/or itsemployees neither bear nor assume any responsibility whatsoever for the verification or completeness of the Applicant Information.In addition, I authorize Cooper Square Realty, Inc. to share the Applicant Information, or portions of it, with any other parties theymay reasonably believe necessary to fulfill the purposes of this application. Transfer of the Applicant Information may be made inany form, including but not limited to mail, overnight courier, facsimile, email or posting on a secure/password protected web site. Ifurther agree to hold Cooper Square Realty, Inc. harmless from any error or omission in the transfer of the Applicant Information or

from the consequences of the distribution of the Applicant Information to third parties.

XApplicant Date



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Phone: 212-634-8900 Fax: 212-634-3946

Part 2 Financial Information

Applicant: Co-Applicant:Address: Address:

Monthly Housing Expenses

Income: Applicant Co-Applicant Expenses:Applicant(present)

Co-Applicant(present)

Total(during lease)

Base monthly salary: Rent:Overtime (monthly): Maintenance:Bonuses (monthly): Mortgages/Loan:Commissions (monthly): Hazard insurance:Dividends/Interest: Real estate taxes:Net rental income: Other expenses*:Other income:TOTAL: TOTAL:

Assets & Liabilities *Related directly to housing or debt(not personal expenses)

Assets: Applicant Co-Applicant Liabilities Applicant(present) Co-Applicant(present)

Cash (Schedule A): Notes payable to banks:Contract deposit: Notes payable to relatives:Stocks & bonds (Schedule B): Notes payable to others:Investment in business: Install accounts payable:Accounts receivable: Automobile:Real estate (Schedule C): Other accounts payable:Automobiles: Mortgages payable:Personal property: Unpaid real estate taxes:Life insurance(cash value): Unpaid income taxes:Retirement funds/IRA: Chattel mortgages:401k: Loans on life insurance:KEOGH: Credit card debt:Profit sharing/pension: Other debts:Other assets (Schedule D):TOTAL: TOTAL:

Itemized Schedule of Assets & LiabilitiesSchedule A Cash (attach additional pages if necessary) Total should match cash line aboveApplicant or Co-Applicant Financial Institution Type of account Account Balance

Itemized Schedule of Assets & Liabilities (continued)Schedule B Stock, Bonds and Mutual Funds (attach additional pages if necessary) Total Should match Stocks & Bonds LineAbove

Amount of shares Description Marketable value Non-marketable value


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Phone: 212-634-8900 Fax: 212-634-3946

Itemized Schedule of Assets & Liabilities (continued)Schedule C Real Estate (attach additional pages if necessary)Applicant orCo-applicant

Property Address Type of Property Amount ofMortgage/liens

MortgagePayment

Insurance main, tax &misc.

Itemized Schedule of Assets & Liabilities (continued)Schedule D Other Assets (attach additional pages if necessary)

Explanation:

IF YOU ARE A PRINCIPAL OF OR ARE EMPLOYED BY A FAMILY BUSINESS, PLEASE COMEPLETE THIS SECTION:Applicant Co-Applicant

Dividend or partnership income (present year)Dividend or partnership income (prior year)

Dividend or partnership income (second prior year)

DECLARIATIONSAre there any outstanding judgments against you?

Have you been declared bankrupt in the past 7 years?Have you had a property foreclosed upon or given title or deed in lieu thereof in the past

7 years?Are you a party to a lawsuit?

Have you directly or indirectly been obligated on any loan that resulted in foreclosure,transfer or title in lieu of foreclosure or judgment?

Are you presently delinquent or in default on any Federal debt or any other loan,mortgage, financial obligation, bond or loan guarantee?

Are you obligated to pay alimony, child support, or separate maintenance?Is any part of the down payment borrowed?Are you a co-maker or endorser on a note?

Do you intend to occupy the property as your primary residence?Have you had ownership interest in a property in the last 3 years?If yes, what type of property did you own?

How did you hold title to the property?

The foregoing application has been carefully prepared, and the undersigned hereby solemnly declare(s) and certify(s) that allinformation contained herein is true and correct. The information is submitted as being a true and accurate statement of the financialcondition of the undersigned on the __________ day of ______________, 20___.

XApplicant Date



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NOTICE OF INTENT OF LEASE

Board of ManagersThe Fitzgerald Condominium

c/o Cooper Square Realty6 East 43rd StreetNew York, NY 10017

RE: The Fitzgerald Condominium201 West 74th StreetApartment _______

Dear Sirs:

This letter will serve as formal notice of the undersigned unit owners intention to lease

the above referenced apartment. In accordance with the By-Laws, the followinginformation is being submitted for your consideration.

Name of Proposed Tenant(s):

Current Resident Address:

Monthly Rent: $

Lease Term Commencing: Ending:

In addition, the undersigned will provide you with such other information as you mayreasonably request.

Sincerely,

BY:Unit Owner

BY:Unit Owner


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The Board of Managers

The Fitzgerald Condominium

Cooper Square Realty6 East 43rd

Street

New York, NY 10017

RE: Apartment


201 West 74th

Street

New York, NY

I understand and agree that I am responsible for any and all damage done to the building

by myself and/or any person helping me or in my employ to move my belongings into thebuilding.

I agree that on the day of my move, I will meet with the buildings superintendent and

walk through the building to inspect the condition of lobby, elevator, and hallway.

In addition, at the end of the day when the move-in has been completed, I will notify the

buildings superintendent so that we can inspect the premises to insure that the buildings

condition has not been changed from my move.

Acknowledge and agreed to:

Applicant

Co-Applicant

Dated:


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The Board of Managers


Cooper Square Realty

6 East 43rd

Street

New York, NY 10017

RE: Apartment_________


201 West 74

th

StreetNew York, NY

I understand and agree that no move-in to this apartment will be allowed until the

Managing Agent receives the following documents:

- Notification Letter and/or recorded Unit Owner Power of Attorney.- Certificate of Insurance as outlined in sales application.

Acknowledged and agreed to:

Applicant

Co-Applicant

Dated:


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NOTIFICATION OF LEGAL MAILING ADDRESS FOR UNIT OWNER

Unit# _____________

All communications and invoices concerning the ownership of Unit _______ should besent to the following address rather than to the apartment.

Name: _______________________________________________________________________________________

Address: _____________________________________________________________________________________

Telephone (home): _____________________________ (office) ____________________________________

Mobile: _________________________________________ E-mail: ____________________________________


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6 East 43rd Street 14th Floor New York, New York 10017 212-682-7373 Fax: 212-682-5441

House Rules & Regulations Acknowledgement Form

Apartment# _________

Building: ____________________________________

I (We) have read the rules and regulations for the referenced property and hereby agreeto abide by said rules and regulations.

___________________________________ _______________________________Purchaser/Lessee (Signature) Date

___________________________________ _______________________________Purchaser/Lessee (Signature) Date


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Printed using pcFORMation Software, v. 4/96, 408-947-2107

pcFORMation

Disclosure of Information on Lead-Based Paint and/or Lead-Based Paint Hazards

Lead Warning StatementHousing built before 1978 may contain lead-based paint. Lead from paint, paint chips, and dust can pose

health hazards if not managed properly. Lead exposure is especially harmful to young children and preg-

nant women. Before renting pre-1978 housing, lessors must disclose the presence of known lead-basedpaint and/or lead-based paint hazards in the dwelling. Lessees must also receive a federally approved

pamphlet on lead poisoning prevention.

Lessors Disclosure.(a) Presence of lead-based paint and/or lead-based paint hazards (Check (i) or (ii) below):

(i)_____Known lead-based paint and/or lead-based paint hazards are present in the housing (explain).____________________________________________________________________________

(ii)_____Lessor has no knowledge of lead-based paint and/or lead-based paint hazards in the housing.(b) Records and reports available to lessor (Check (i) or (ii) below):

(i)_____Lessor has provided the Lessee with all available records and reports pertaining to lead-based paint

and/or lead-based paint hazards in the housing (list documents below).____________________________________________________________________________(ii)_____Lessor has no reports or records pertaining to lead-based paint and/or lead-based paint hazards inthe housing.

Lessees Acknowledgment(initial)(c)_____Lessee has received copies of all information listed above.(d)_____Lessee has received the pamphlet Protect Your Family from Lead In Your Home.

Agents Acknowledgment (initial)(e)_____Agent has informed the lessor of the lessors obligations under 42 U.S.C. 4852d and is aware of

his/her responsibility to ensure compliance.

Certification of AccuracyThe following parties have reviewed the information above and certify, to the best of their knowledge, that

the information they have provided is true and accurate.

________________ ________________ ________________ ________________ Lessor Date Lessor Date

________________ ________________ ________________ ________________ Lessee Date Lessee Date

________________ ________________ ________________ ________________ Agent Date Agent Date

PCF11295

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