Name

First Name

Last Name

Direct Phone Number

(###)

###

####

Company Contact Information

Company Name

Physical Address

City, State, Zip

Lease Information

Current Square Footage

Lease Expiration Date

YYYY

Do you have a Right to Terminate?

Yes

Right to Terminate Date

(If applicable)

YYYY

Current Monthly Rent

Scheduled Future Rent Increases

(Please specify rate increase and effective date.)

Please specify desired changes (if any) to your current layout:

Additional Notes or Inquiries:

Thank you for inquiry. We will contact you to discuss your potential Lease Restructure as soon as possible.

Restructure Inquiry