Vendor Application - Click here for printable application.

Business/Commercial Application: Water Tower Farmer’s Market
Term Requested:   Month-to-Month | 3 months | 6 months | Other___________
Contact for this Application:
Date:__________
Contact for this Application:
Name:_______________________________________Phone Number: ____________________
Cell Number: ____________________________ E-mail address__________________________
Sole Proprietor:
Name:_______________________________________Position:__________________________
SSN: _______________________Driver’s License Number______________________DOB:__________
Name of Corporation (As licensed to do Business in Florida):____________________________
Registry:____________________Tax ID:_________________Date Established:_____________
Type of Business:____________________________Monthly Net Income:______________________
Bank Reference: Bank Name: _____________________________________________________
Contact:___________________Phone Number:_______________ Fax Number:_____________
Present Business Address:________________________________________________________
City: State: Zip: __________________________
Present Landlord: ______________________________________________________________
City: State: Zip: __________________________ Years Doing Business at the Address:________
Current Monthly Rent:_____________________
Why are you moving:____________________________________________________________
List Three References:
1. Business Name ____________________ Account Number_____________
Contact Name_____________________ Phone Number____________Years Known___
2. Business Name ____________________ Account Number_____________
Contact Name_____________________ Phone Number____________Years Known___
3. Business Name ____________________ Account Number_____________
Contact Name_____________________ Phone Number____________Years Known___
Has the business ever filed bankruptcy? ______________________________________________
If yes, what date, county, and state is the bankruptcy filed? ______________________________
Has the Business ever been evicted with or without court proceedings from any rental unit?
______________________________________________________________________________
Has the business ever willfully and/or intentionally refused to pay rent when due?
______________________________________________________________________________
Have you or any other person named on this application ever been convicted of dealing or manufacturing illegal drugs? ______________________________________________________
Has the applicant, co applicant or spouse ever been convicted of a crime? __________________
If yes, what were the nature of the crime and the date of the conviction? _____________________

 
Ley-Quin Inc. 941-962-0769 Joey’s Plaza/Water Tower Farmer’s Market
I offer the foregoing information as inducement to commercial property management, Ley-Quin Inc. to lease me a rental unit, I declare the foregoing information to be true and correct and do hereby authorize Ley-Quin Inc. to conduct a criminal and credit check and to verify these references.
I understand I will be denied if I have misrepresented any information on this application, and if misrepresentations are found after a lease agreement is signed, my tenancy is subject to termination.
I /We have read, understand and have had any questions answered regarding the above information.

Signature of Business Applicant:________________Date:_______________________________
Signature of Co-Applicant:____________________ Date:_______________________________