_UNITMIIST_BKPRIMARYREDlDENCEQF THEVNJIOWNEIlTHE FIRST 2 YEARS,

SUMMARY DATA:

APPLICATION FOR PROPOSED SUBLET Curzon House Owners Corp,

83-80 1181" Street

APARTMENT NUMBER: ____________ ,MONTHLY RENT: ________________________ __

PROPOSED TENANT: ________ T.ENANT SOCIAL SECURITY #:. __________ _

CURRENT HOME NUMBER ______ -OFFICE NUMBER. _____________ _

OWNER{S)NAME _____________________________________________________ ___

OWNER PHONE: DAY __________________________ ,EVENING, _______________ _

OWNER{S) FORWARDING ADDRESS: __________________________ _

ITEMS REQUIRED FROM EACH SUBTENANT: . • COPY OF SUBLEASE (BLUMBERG FORM, ATTACHED) • FOUR (4) REFERENCE LETTERS FOR EACH LESSEE (2 BUSINESS AND 2 PERSONAL) • LAST TWO YEAR'S FEDERAL TAX RETURNS AND W2 FORM • COPY OF THE TWO MOST RECENT PAYSTUBS • COPY OF THE TWO MOST RECENT BANK STATEMENT FROM ALL ACCOUNTS

FEES:

$100 NON REFUNDABLE PROCESSING FEE (PAYABLE TO Curzon House Owners Corp.) $300 NON REFUNDABLE PROCESSING FEE (pAYABLE TO THE ARGO CORP) $45.00 PER PERSON CREDIT CHECK FEE (PAYABLE TO THE ARGO CORP) $100 MOVE-OUT FEE (PAYABLE TO: Curzon House Owners Corp.) $100 MOVE-IN FEE (PAYABLE TO: Curzon House Owners Corp.) $300.00 MOVE-IN SECURITY DEPOSIT MUST BE SUBMITTED WITH THIS APPLICATION

(PAYABLE TO Curzon House Owners Corp.) $300.00 MOVE-OUT SECURITY DEPOSIT MUST BE SUBMITTED WITH THIS APPLICATION

(PAYABLE TO Curzon House Owners Corp.)

AUTHORIZATION OF ELECTRONIC DEBIT: You are hereby on notice that all checks submitted to this office can be processed electronically, at first presentment and any re-presentments, by transmitting the amount of the check, routing number, account number and check serial number to your financial institution. By submitting a check for payment, you are authorizing us to initiate an electronic debit from your bank or asset account as early as the same day the check is received in our office. Please note that you will not receive a cancelled check with your bank or asset account statement with respect to any checks processed electronically, but such amounts will appear as debits on the statement issued by your bank or asset account.

PLEASE SUBMIT ORIGINAL AND 2 COMPLETE COLLATED SETS OF THE ABOVE DOCUMENTS AND THE ITEMS REQUIRED, ALONG WITH YOUR FEE, DIRECTLY TO:

COOPERATIVE CLOSING DEPARTMENT THE ARGO CORPORATION

50 WEST 17'" STREET _7'h FLOOR NEW YORK, NY 10011

ALL INQUIRES CONCERNING APPLICATION AND INTERVIEW PROCEDURES SHOULD BE DIRECTED TO THE COOPERATIVE CLOSING DEPARTMENT AT THE ARGO CORPORATION (212) 896-8697

NO APPLICATION WILL BE CONSIDERED UNLESS IT IS COMPLETE PLEASE BE ADVICE THAT A SUBTENANT MAY NOT MOVE ANY BELONGS OF THEMSEVES INTO THIS APARTMENT WITHOUT FIRST BEING INTERVIEWED BY THE BOARD OF DIRECTORS AND FULLY APPROVED.

THERE IS A SUBLET FEE EQUAL TO 15% OF ONE MONTH'S MAINTENANCE, BILLED MONTHLY.

'.."

; ---TENANT -APPLicAiiorf --------~ L ________________________________ J

THE ARGO CORPORATION APPLICATION TO SUBLET APARTMENT- Part 1 TENANT: PLEASE COMPLETE EACH ITEM ON THIS PAGE.

(Co-tenant or grnn\or mllit ocmplew separate application, as provided in this paclcage)

TENANT'SNAME:, _________________________ _

SOCIAL SECURITY NUMBER: ________________________ _

TELEPHONE: HOME, __________ WORK, ___________ _

CURRENT ADDRESS: _______________________ _

HOW LONG HAVE YOU LIVEDATTmS ADDRESS1: _________________ _

LANDLORD NAMlI& ADDRESS: ______________________ _

PRIORADDRESS: __________________________ _

HOW LONG DID YOU LIVE ATTmSADj)RESS~: ______________ _

NAME & ADDRESS OF EMPLOYER, ______________________ _

WHAT IS YOUR POSITION?: ________________________ _

Howlong? _______ _ WeeklyS.lary? ______________ _

HoW often do you -receive a salary t:beck?: Weekly,? ___ Bj..Weekly? ___ Monthly? __ _

Ot" •• , _____________________________ _

SAVINGS ACCOUNT AT' _____________________ _

CHECKING ACCOUNT AT:, _____________________ _

ARE YOU OVER 21VRS OF AGE: ¥EsLi NOD ..... DO YOU OWN ANY REAL PROPERTY? vESLI NoLI If"YES'' where! ______________________________ _

DO YOU OWN A CO·OY OR CONDO APARTMENT? YESO NOLlIf"¥ES" wb .... ? _______ _

THE FOLLOWING QUESTIONS MUST BE ANSWERED "YES", "NO", OR "N/A" (not applicable) If YES, please explain in detail, on sop.raw sheet of pape" & albch to appfi.otion.

Have you any oUhtandingjudgements against you? Have you had property forulosed Upoo, Or given tit""I.-.-,-cd;-.-,-.d,.-j;-.-;I;-i .. -::tb;-.-reo--=!'I;c---------lLI.ve you WeI' been involved iDa bHTIkruptey?: __________________ _ Are you a COvJJlI'lkl:1' or endorser off! Dote? ____________________ _

Are yon a party in 8laWSDit?, __ """"--o-_____ -._-c_-....,~------_--Are you obligated to pay aJjmony, child support or separatioD maintmad"? ________ _

. ..."

i:: ::~~~!t~! £~~pf·!.}(~~~I!c~~!-:::::: THE ARGO CORPORATION

APPLICATION TO SUBLET APARTMENT - P.rtTwo

BUILDING ADDRESS OF REQUESTED SUBLET:: __________ VNTT ____ _

Apllrlmt:JIt me/til of BedrvIlJmi';, ___ _

SUBLEASE PROPOSED TO BEGIN:: ________________ EXPIRE: __________ _

MONTHLY RENTAL PRlCE:$, ____ ~ANNUAL RENTAL PRlCE:$, ____ _

SECURITY PEPOSlT: S, _____ Any olber conslderatioD to b. paid by'OD .. I(.)1 ____ _

Persons who will occupy this llp3rtmcnt besides tenlloE and co-tenants?

Name: Rela1lo_ship: Age:

Name: Relatioldshlp: Age:

Name; Rela1ionsflip: Age:

Name: Relatlonsblp: Age::

Do you plan to keep any pets in tbis apartment? Ifyu, please describe:

................. m .................................................................................................................. , ......................... , ..................... ..

STATEMENT OF INCOME

~ ___ ~ __ ~T=.=n=.n~t~ ______ -=C=~:T=~==.n~' ______ -=G=u=.=n=.=w=r~ ___________ _ Base S8IBr)':_ Overtime Salary:' ___________________________________ _

BonDs~::~------------------------------------------------------Commissions::--,-___________________________________________ _ P;vidend. & 'olor ... :' ________________________________ _ Rcal Estnte lncome:: ___________________________________________ _ O1berIDcome,~· _________________________________________________ __ T{)taJ Ioc:ome: ___________________________________________________ _

STATEMENT OF EXPENSES Please list all regualr and predictable expenses. monthly/periodic payments on loans: (auto.mortgagc,persona.l,student), alimony and child support. List payee, Item, amount and frequency of payments, Please spec.ify Tenant or Co-tenant:

--------------------------------------~$---------______________________________________ ~S~ ________ ___

---------------------------------------~$.-----------------------------------------------~$--------------------------------------------------------$~---------________________________________________ $, ________ _

---------------------------------------------$,-------­__________________________________________ S~--__ ------_______________________________________ S, ______ ___

-----------------------------------------_$_----------------------------------------------------$~-----------------------------------------------$,------------------------------------------------_$---------____________________________________________ $, ________ _

---------------------------------------------$,---------

PfiIltt3

THE ARGO CORPORATION APPLICATION TO SUBLET APARThlENT

CO-TENANT: PLEASE COMPLETE EACH ITEM ON THIS PAGE.

TENANT'SNAME: _________________________ _

SOCIAL SECURITY NUM8ER:, ________________________ __

TELEPHONE: HOME, __________ WORK ___________ _

CURRENT ADDRESS, _________________________ _

HOW LONG HAVE YOU LIVED AT THIS ADDIUlSS?: __________________ _

LANDLORD NAME & APPIUlSS:, ______________________ _

PruORADDRE~;. __________________________ _

HOW LONG DID YOU LIVE AT THIS ADDRESS?: ______________ _ .... -.... _ ................... - .... _ .............................. __ ............................ - .............................................. -_ ............................. . NAME"" ADDRESS OF EMPLOVER'~ _____________________ _

WHAT IS YOURPOSITION?' ________________________ _

How Iong? _______ _ Weekly SnJaryf ________________ _

How often do you recelve a salary check?: Weeldy? ____ B,i-Weekly? __ --.JMolltbly? __ _

Ofuer:' ___________________________ _

SAVTNGSACCOUNTAT' ______________________ _

CHECKlNGACCOUNTAT', _____________________ _

ARE YOU OVER 21 YRS OF AGE; VESO NOO ..... DO YOU OWN ANY REAL PROPERTY! VESO NOO ICnYES'" wllerf!? _______________________________ _

PO YOU OWN A CO-OP OR CONDO APARTMENT? ¥ESC! NOO If "VES" wb ... ? _______ _

THE FOLLOWING QUESTIONS MUST BE ANSWERED "YES", "NO", OR "N/A" (not applicable) If YES, please explain In detail, on separate sheet of paper, & attach to application_

Have you any o~tsta .. ding judgements aga,inst you?,,-:;-;-:::-;;---;;-=;;---_______ _ Have yon bad property fOT'eclosed upon, or given title or deed in lieu ther'eoi? ________ _ Have YOB eVer been involved ina bankruptc:y? __________________ _ Ate YOD a ~o-maker {lJ' elldorticr ofa notc? ___________________ _ Are YOD a party in a lawsuit? __ -:-::-:-__ ,-__ --,,-_-, __ ----;,-________ _ Aro you obligated to pay alimony, child support or separation mainttnanu7 _________ _

THE ARGO CORPORAllON APPLICATION TO SUBLET APARTMENT

GUARANTOR; PLEASE,COMPLETE EACH ITEM ON THIS PAGE

GUARANTORNAME;, _____________________________________________ ___

SOC~LSEcuruTYNVMBER;; ____________________________________________ __

TELEPHONE: HOME, ____________ WORK, ________________ __

CURRENTADD~S:, __________________________________________ ___

HOW LONG RAVE YOU LIVED AT THIS AUURESS?:. ____________________ _

LANULORDNAME&AUURESS:, ____ ~ ______________ ~-------

PruORADDR~S:, _____________________________________________ _

!lOW WNG Dro yoU LIVE AT THIS ADDRES8?:' _____________________ _

............................................. , ..................................... " .. , ................................................... , ........................................... . NAME & ADDRESS OF EMPLOYER' _____________________________________ _

WHAT IS YOUR POSITION?:, ___________________________ _

How long1 _______ _ Weekly S.lory?' __________________ __

How ofteco du you reeeive a ulary c.h«k?: Weeldy? ___ ~B ... W eekly? ____ Monthly? ____ _

Other:' _______________________________________________ _

............... m ...................... , ........................................................... , ................................................. , ................................. .

SAVINGS ACCOUNTAT,, _________________________ _

CHECK~GACCOUNTAT', ______________________________________ ___

ARE VOU OVER llYRS OF AGE, YESO NOO .... DO YOU OWN ANY REAL PROPERTY? YESO NOD If''YES" wh~t?' ________________________________________ __

DO YOU OWN A Co.OP OR CONDO APARTMENT? YESO NOO If "YES" where?, _________ __

THE FOLLOWING QUESTIONS MUST BE ANSWERED "YES", "NO", OR "NIA" (not applicable) If YES, please explain in detail, on separate sheet of paper, & attach to application.

Haveyou any olitstandingjDdgements ~gainst yOu?,.,.... __ 7c--c' ___ .....,,-. ________ _

Have you had prl}perty foreclosed upon, [101' given title or deed AI lieu 1hereof?" _________ _ H;n'e you ever been iavolved ina b30kruptcy?, ________________________ _ Arc you a eo-maker 0 .. endorser ora .~te?r __________________________ _

Are)'Ou R party in a lawsuit?, _____ ------------------------------. Are you obligated to pay aUmonf, thlM sU"ppvrt or separation maiRtenance1: _________ _

WINDOW GUARDS REOUIRED

LEASE NOTICE TO TENANT

You are required by law to bave windoW guards installed if a child 10 years of age or younger lives in your apartment.

Your Landlord is required by law to install window guards in you apartment:

• If you ask him to put in window guard at any time (you need not give a reason)

• If a child 10 years of age or younger lives in your apartment.

It is a yiolation of law to refuse, interfere with installation, remove window guards where reqUired.

CHECK ONE

CHILDREN 10 YEARS OF AGE OR YOUNGER LlVE IN MY APARTMENT

NO CHILDREN 10 YEARS OF AGE OR YOUNGER LIVE IN MY APARTMENT

I WANT WINDOW GUARDS EVEN THOUGH I HAVE NO CfllLDREN 10 YEARS OF AGE OR YOUNGER

TENANT NAME (PRINT)

TENANT SIGNATURE

FOR FURTHER INFORMATION CALL: Window Falls Prevention Program

New York City Department of Health 125 Worth Street, Room 222A

New York, NY 10013 (1.212.566-8082)

920-S "

Disclosure ofinformation on Lead-based Paint andlor Lead-Based Paint Hazards

RENTALS Lead Warning Statement Housing built before 1975 may contain lead-based paint Lead form paint, paint chips, and dust can pose health hazards if not managed properly, Lead exposure is especially harmful to young children and pregnant woman, Before renting pre-1978 housing, lessors must disclose the presence of known lead-based paint andlor lead-based paint hazards in the dwelling, Lessees must also roceive a federally approved pamphlet on lead poisoning prevention,

,

Lessor's Disclosure (a> Presence of lead-based paint andlor lead-based paint hazards (Check (i) or no below): (i) _ Known lead-based paint andlor lead;based paint hazards are present in the

housing (explain): ............ ,' .... , ............ , ................ , .. , .. , ...... ,', ....... ,"" ••••••••• _ •••••••••••• , ••••• , ••••••••• 0 ••••••••••••• to ••••••••••••••••••• , ••••••••••••••••••••••••••••

• '0 •• ' ••••.••••• , •••.•••••••••.••• '" ••••. , .•••••••• to ••••• _, •• _ ••••••••••• , •••••••••••••••••• , ••• , •••

(ii) _ Lessor has no knowledge ofJead-based paint andlor lead-based paint hazards aro present in the housing,

(b) Records and reports available to the 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),

••••• 0 ••••••• , ••••••• 00 ••• _ ••••••••••• '.0 ••••••••••••• o •• 0 •••••••• , ••• 0 .................... 0 ••••••• , .. ..

......................................................................................................

(ii) _ Lessor has no records or reports pertaining to lead-based paint andlor lead­based paint hazards in the housing.

Lessee's 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 Horne.

Agent's Acknowledgment (initial) <eJ __ Agent has informed the lessor of the lessor's obligations under 42 U,S.C.

4852d and is aware ofhislher responsibility to ensure compliance,

Certification of Accuracy The 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 l.ESSOR DATE

LESSEE DAtE LESSEE DATE

AGENT DATE AGENT DATE

Dote Dflhia: 5dhJea"&c:

Parties to lbia . Subl~.el

Information rtom OVClr·Leblie;

Terrol

J?rcm4ca rented:

UsC! of premlatll:

SUBLEASE AGREEMENT The parlies agree tlS follows:

19

Overlen&nt: Addrcn lor notice5:

You. the Utldcrl~llan~: AtldrMs lor nuUCCS:

H there fltc mora lhan one Orerlt:lnllnl Ct Umlc.r1enBtll, the words "OI'CrlenRTlI" anrl "Undertenllnl" ll&(:d in IM8 SlIbl.;:iI:;O mcluJes them.

wndlord: Alhltess fot notIces I

Overlonan1: AcJdre5l1 for l1oliee$:

19

Term: from: 19 100: 19 A (lDP')' of t~ Ovcr-i.euc Is IIUitchcd 1115 In tmpOi1(1nll'llrl or th~ Sublf!lli5~.

I. YOlln: 11I0IlIlm DClJinnhllJ: 19 ending: 19

Z.

3- The prenli~elI may be IISed for 00.1),.

Rent; 4. The yearly rent ill S • You, Inc Undo.."'tcnl\nl, wlll 1'1)' 1M, yearly ren~ 10 1&0 Ot'llr.

Security: 5.

ABTcement to lea" ,. Md l'~)' rent r

Notlce~: 1.

Subjed.lo$ B.

Ovethmant'a dutleJ; 9.

lenant 1n n"clve equal monilily payments or $ • PaymBJ1111 ilhllll be pu[d In ndvpncc 011 tho fir~l day of !lIlO!' month dlldng Ihe Terln.

Th8 ~titl' Inr Ihe UJ\derlenllnt'a. pcdol'nlllJ1ee ii$ . OVCrlCTlllltUllalts Ih~t Ovor· tenonl ]'11:1 rcr:~Y~ it. O\'trfOIlIlDt shllillutltl til" security in :lccDmtlnCC wIth J'llrngrnph 9f Ihe Over' Lease.

Oyr;ttcmml ,ub!cllllIJt prcmlllOS to yOll, lito Ul\dcr!(I:J)Dn~. ror Iho Term. OvllrllmftRllIlllCll Ill,,! it hilS 1m (l1Jt110rity 10 do SII. YII1l. Ihe U»derlIlJlIITll, IISTce 10 por tho Rent dlUl olher chArges nil required in Ibe Sul •• lenac. You,. Ihe Underhmnnl, i'lgr\le to <10 6vtrrthil\8 Nl'1l1irC,1 of ),.011 in the SlIbbl5e.

J\D natled In tbe Stlblc.Q80 cball be .IIc~1 1>)' c:ertinr.d moil, "relurn recelpl roq\IC81cQ".

The SublcllSc i.s &l.Ibjecl 10 tho Ovcr~Lcilsc. fl is "Iso subject t~ an)' agr;:emcn1lo wh[ch the Ovor.Le,uie Is I:m&joct. You, the Underlemllfll, slnle Ihal you ha,e relld ltnd initialed the Over. tease Dnd will 1101 yil;olJtlI< it in qlljl' I~Al.

The OVBt·[,eIlI5C (lc~rihe5 the Landlord's (lutio!. Tile OVe!ltcnDJll IS not DbJi,a:nted to perfotm the; wod­lorLl's dutie3. H Ihe LRhdl~d £aili!! tQ )ler£Onn, you,- Ihe UnJcnenlllll, muM sond the OvertenRnt II :notice. 'Upon receipt of the no!icg, tho OVcrtl:'llanl shalt tllen promptly l10Ufy tlla -lAndlord find demllnd that Ihll

,Owr.LeBsc tlgn:cll1eJlIS be corried out. 111c Overlclllmt shnD conlfnut the ,ltrlTlllld9 unlllllHI Landlord pe:rr ... rllllJ.

C"mvnt: 10. Ilille r."lJldlofll't cOMenl to the Sublease i", rflqulMd, this C!onOOllt must. be rccc:il'ed wllbln aap

Adopting the Over--Lea5C I1l1d

exoeptiomJ

from de du~ oflhill SubJeMe. If IJle l.!llIdJord'lI consent Is nol reOOtved wilbin thie ti~ tbe Subl6flllC will be void. In 1111<:11 eV~l1t atl parties IlrC! nulOmtilicllly re~'lll5<ld nnd aU paymlllll!l sball bo rcfllnde\"llo you. tIle UndCrien;!nl.

11. The Ilrovi:lionll of the Over·LlJaae Me pun or lMa SlIblCQSI! ..... lIthQ provu.lQJlIl' or 1\111 O'loY'.LetilH!lllpplymS­to th~ OVortcnDJ'lt Gro Mndtng on )'OUt tlle Undertenlim, o;1Xtepl ,h,*;

a) TheZIU I1llmbared Jlsrasraplu or tht: Ol"llr.LotulC's!lIdl not IIpply: \

No authority; 12. Ytlll •. lht·Urull.'tlenanl. hove 110 nUlhnril.y In cOnlac:l (lr mllke IIny Bgreemenl wilh Ih" LandlC'lrd about the pr('nlll;~5 ar Ihe Ovel··I.e;.~. YOII. the Untll'rtcnanl. may !lot?"-Y relit Ilr odmr clllirgesio the Landlord but only 10 tile OV\:l'teRBllt. '. t

Succe"o~: ]3, Uillea othr;'l"wisc &lnlen, lilt: Sublease is hindin; un nil parties !rho luwlllllr SIIe<:ctd to the fiShl! or lake Ille I'la<::c 01 lire Ovcrlenanl or ~u. Iile UllItcrlenonl. EXllrl,plcs nre IVI D5~gll. 11!!ir. or '" legal reprcscn. Ililiva ~lIcb ar; Qll execrllnr of y-tmr will or 1It1l\1ini~nllor or your estate. .

ChanfeJI 14, This sublease cnn I'e thl\ngc" ouly hy .!Ill 1I{!((:cmcnt in wriljps .iGucd hy Ille panit610 ~ho Sll}-tl~uM:\'.

5ig:paha~J; OV£RTENANT:

.......... " .......................... , .. , ..... ,_ ... , ....................... ~ .. '." ................................. ~." ..... , .................. .. Yml, the UNDERTENANT:

Wilnrus: ..... ,~ ... ,-.................. , .............................................. " ... , ........................................................ _ ................. ..

GUARANTY OF PAYMENT WHICH IS PART OF THE SUBLEASE

GUatClntor lind "~drae:

RlIl'astm EoI' CUftrllonlyr

ChangOI' in Sllbtell.''IC h~ve

nCo elfec.t:

WaiveroEaodce:

Perfomumoe I

Waiver of jur" Irl"l:

Cbru1gel:

19

1. I know Ihnt the Overlemml would 1101 relit tlla pI'emise~ 10 lIu! Ul1QeJ1cnanl IJIllc$1i J ~aranlee Under. ump;n\'s perfornlarn:c. I 11"\'1; f,!~O r!!'lltI'e-l'IOcl tllll O~C'rtI!'IH.lIlIIO 1::IIlcl' ,nto ~le5ubhHlsll Willi the. UnderlijnMIII. r have 11 :!ul.ifllllilil bll\1JC!9: in tntlki:l~ SlIre Iho\ Ihe Ovarten;1Il1 remls Ih~ prC!rni~cs 10 lhe Unclcrlenanl.

2, The following is my CUUllIlI)'l r GUU:llllr the full I)~rform~mcc of tbe SUhlCR~ by lhe UntlcIICfltln!. 'Thi~ GunnnlY i!l Ab!lDI~t~ lliUt: with­lint lilly t,;QllIli[lolI. I il'1I::llIdo:1l. but is 1101 I;mill:d lo, Ihe 11Ilymeilt of rent lind olher monl.!Y that(;es •

. III addition, T I18rllt'! to tl\c,e other IlInn~: 3. Tills Cuaronly ,viII !)alba JfIecll.!d by IInJ chl1ngc III Ihe SlJbIGD~. WhatsDC\'er. 'fhi, Jncllld~, bill is not

limited to. any cxlenUon of rime or I'<Incwllb. The c;.uanmly wm be blndiflG \lyen if I am nol II par1y 10 tlt\:~e chengell.

4. I d~ not lun'''' 10 be infornui.d about allo)' failure gf ·pcrrgrma.~1;C by Undert~llnt. I wnl"!!: nOliee of Ilon. Pll1mtflt Gr nonperformAnc;C!. ~ •

5. It Ihc Ullderlenolll r<lj!" to ~rfo2'm unrer the: ~ublcl:lse. lho: O,erlmant nray I~i\.llru III.' IQ IXlriorm wilk­Ollt firsl Ilemsnding llial tIle 1Ilidertcnlln! J)t'r(onll.

6. I give lip my right 10 lrinl hy jury in any claim related [0 rlle Stlble:p$~ \>r lnis GUflfllRly.

7. This GLlPranlY of paymenl lIf'1ct PCTrOtJllimee C6n I>e ch1mllwonly by wrillcn agreema:nt lIigned by all p"rlies 10 the Sublease Mel GUllranly.

GUMt'NTOl\, WITNESS,

..................... , ............................. :~ ................. ..

:epA and HUD Lead Pnlnt Regufoilons, Ql'ectil'c Seplenlbel' 6, 1996' Landlal'di; must dist:looe kTtown ]ead·bflScd palnlllnd (utd·bnsed polnl hazlrd5 Qr pre--1978 hou~ing 10 lel1anls.; Usc: the foUowlng: BLUMBBROLAW PRODUCTS (809 LAW MART) 10 comply:

3140 Leaa PAint lnrormellion BOOklet 3141 Lelld Pp.inl LeISe Disclosure Form 'Deccm~6" 1'196 ftll OIllDeO of 110 4 r~loj~nlldl dl'lflllnGI. 'lCD5I:'I rot fl:n IhM 100 \layJ,O·b~room Iinils. &krly An" h:lohfi\::lppr:l.Ilmulln& (unl.a.; c:hildn::n live lhejl!) nne) hllll51ng' rl)l~d 10 be: In.J.rrcc II)'. c~nmed

1nsrre")Of lire CKoluEh;:d.

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367117

LEAD PAINT RIDER - COOPERATIVE

RIDER TO LEASE

dated as of---:,--___ ~, 20_ between

________ -,-___ -" Landlord

and

____________ ~-----~,Tenant regarding

Apartment ___ (the "Unit")

___ " New York

I, Sublease is subject and subordinate.

This rider is subject and subordinate to the Proprietary Lease, By-laWS and Rules and Regulations oflhe (the "Apartment Corporation"), to which the Unit is presently or may in the future be subject, Landlord and Tenant shall not perform any act, or fail to perform any act, if the performance or failure to perform would be a violation of or default of the Proprietary Lease or Rules and Regulations. Tenant shall not exercise any right or privilege under this Sublease, the performance of which would be a default in or violation of the Proprietary Lease or Rules and Regulations. Landlord and Tenant acknowledge that each has, respectively, had the opportunity to read the Proprietary Lease, Rules and Regulations and Local Law (as hereinafter defined) and Landlord and Tenant agree to observe and be bound by all the terms contained in each which apply to the occupancy or use ofthe Unit.

2. Local Law I of2004 ahe New York City Childhood Lead Poisoning Act Of200~).

Pursuant to New York City Local Law I of 2004 entitled the New York City Childhood Lead Poisoning Act of 2003 (hereinafter the "Local Law"), the owner of any apartment in a building constructed prior to 1960 or built between 1960 and 1978 where there is a belief that lead paint is present in the apartment, which contains 3 or more apartments, and where a child under the age of seven (7) resides, must, inter alia, (i) inquire at the initial leasing (and at any renewal) if a child under the age of seven (7) years resides or will reside in the apartment; (ii) notify the tenant of their rights under the Local Law; (iii) send an annual notice to tenants inquiring as to whether there is a child under the age of seven (7) years residing in the apartment; (iv) conduct inspections annually, and more often, if necessary, to detennine if there are any lead paint hazands in the apartment; (v) remediate (in strict accordance with the Local Law) all lead paint hazards in apartments with a child under the age of seven (7) years residing in the apartment; and (vi) make all apartments lead-safe (in strict accordance with the Local Law) when they become vacant

A lead paint hazard is defined as (i) peeling lead-based paint; (ii) deteriorate sub-surfaces (including broken wood frames or moldings or crumbling plaster); (iii) friction surfaces (including Windows in which the painted surfaces scrape against each other); (iv) impact surfaces (including moldings and jambs which may be struck or hit by feet, toys, or opening and closing doors); and (v) chewable surfaces (including all intact winQow sills and protruding surfaces which show evidence of being chewed by children).

3. Compliance with Local Law and Waiver and Indemnification of Apartment Corporation.

Landlord and Tenant each hereby acknowledge and agree that the responsibility for compliance with the Local Law, including all inspections, notices, work and/or remediation required thereunder is the responsibility of the Landlord and not the Apartment Corporation or its shareholders, directors, officers, employees andlor agents andlor their respective successors andlor assigns. Landlord shall, in accordance with the Local Law, inspect the Unit as required and shall remove all lead paint hazards in the Unit in accordance with the Local Law and will provide documentation of such inspection and removal, if applicable, within (5) business days upon request.

Landlord and Tenant, collectively and individually, hereby agree to, release the Apartment Corporation, its shareholders, directors, officers, employees and agents and their respective successors and/or assigns (collectively, the "Indemnified Party''), and shall indemnity, defend and hold harmless the Indemnified Party, from and against all costs, fees (including reasonable attorneys' files), expenses, fines, liability, actions, suits, debts, sums of money, accounts, reckonings, bonds, bills specialties, covenants, contracts, controversies, agreements, promises, variances, trespasses, damages, judgments, extents, executions, claims, and demands whatsoever, in law, admiralty or equity, which against the Landlord or Tenant, their respective families, invitees, guests, heirs, executors, administrators, predecessors, successors andlor assigns ever had, now have or hereafter can shall or may, have f<;>r, upon or by reason of any matter, cause or thing whatsoever relating to any lead paint hazard and the Local Law including, but not limited to, Landlord's responsibility (or failure) to comply therewith.

4. Breach and Additional Remedies.

Landlord or Tenant's failure to comply with any of the provisions of this Rider, or of the Local Law, shall be deemed a material breach of the provisions of the Proprietary Lease between Landlord and the Apartment Corporation.

5. Miscellaneous.

This Rider may not be changed unle~s such change is agreed upon, in writing, by the Apartment Corporation. Captions are for the purposes of convenience of reference only and are not to be considered in interpreting this Agreement This Agreement shall be interpreted and enforced under the laws of the State of New York and any all actions brought hereunder or in connection with the Local Law must be brought in a court of competent jurisdiction in the county in which the Apartment Corporation is located.

Landlord: Tenant:

367117

STATE OF NEW YORK

COUNTY OF ______ _

)

) ss:

On before me, the undersigned, personally appeared -c;-:----;----:c;---:-::--;--;-~' personally known to me or provided to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that helshelthey executed Ihe Same in hislher/their capacity(ies), and that by his/her their signatore(s) on the instrument, the individual(s), or the person upon behalf of which individual(s) acted, executed the instrument. .

Signature and Office of individual laking acknowledgement

STATE OF NEW YORK

COUNTYOF ____________ _

)

) 58:

On before me, the undersigned, personally appeared ----,;-:---,--;--:c;---:-::--;-:-~" personally known to me or provided to me on Ihe basis of satisfactory evidence to be the individual(s) whose name(s) Is (are) subscribed to the within instrument and acknowledged to me that helshe/they executed the same in hislher/their capacity(ies), and that by his/her their signature(s) on the instrument, the individual(s), or the person upon behalf of which individual(s) acted, executed the instrument.

Signature and Office ofindividual taking acknowledgement

STATE OF NEW YORK

COUNTY OF ___________ _

)

) S8:

On before me, the underSigned, personally appeared , personally known to me or provided to me on the basis of satisfactory

-ev...,i"'d-en-oo-----,I,--o-be;--:-th;-e--;-in-d"'jv"""i"'du-a-;;l(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that helshe/they executed the same in hislher/their capacity(ies), and that by hislher their signature(s) on the instrument, the individual(s), or the person upon behalf of which individual(s) acted, executed the instrument.

Signature and Office of individual taJdng acknowledgement

Credit Report Authorization

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I/We authorize Argo Real Estate LLC and or/its agents to obtain a tenant background search or consumer report through CoreLogic Saferent c/o Consumer Relations Department 7300 Westmore Road, Suite 3, Rockville, MD 20850-523 and any other information it deems necessary, for the purpose of evaluating my application. I/We understand that such information may include, but is not limited to credit history, housing court, sex offender search, criminal background check, employment/income verification, prior residency verification and/or any other necessary information. I/We understand that subsequent consumer reports may be obtained and utilized under this authorization in connection with an update, renewal, extension or collection, with respect to or in connection with the rental of a residence for which application was made. I/We agree to hold the above named company and procurer or furnisher of information, free from any liability what-so-ever in the use, procurement, or furnishing of such information. I/We further consent and authorize Argo Real Estate LLC and/or its agents to furnish this information to the Board of Directors, and/or its agents of the cooperative building or condominium to which I/We have applied, or to the Landlord of the rental apartment and his/her agents. Pursuant to federal and state law: 1. If the Landlord takes adverse action against you on the basis of information contained in a tenant

screening report, the Landlord must notify you that such action was taken and supply you with the name and address of the consumer reporting agency that provided the tenant screening report on the basis of which such action was taken;

2. If any adverse action is taken against you based on information contained in a consumer screening report, you have the right to inspect and receive a free copy of the report by contacting the consumer reporting agency;

3. Every tenant or prospective tenant is entitled to one free tenant screening report from each national consumer credit reporting agency (Equifax, Experian and TransUnion) annually, in addition to a credit report that should be obtained from .annualcreditreport. ; and

4. Every tenant or prospective tenant may dispute inaccurate or incorrect information contained in a tenant screening report directly with the consumer reporting agency.

____________________________________________ _________________ Signature of Applicant Date ________________________________________ _______________ Signature of Co-Applicant Date _________________________________________ _______________ Signature of Guarantor Date

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Credit Report Authorization Form

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__________________________________ __________________________________ Applicant’s Name (print) Applicant’s Signature Social Security #:________________________Date of Birth:_______________Phone:_________________ Current Address: ________________________________City: _____________State:________Zip:_______ ______________________________________ __________________________________ Co-Applicant’s Name (print) Co-Applicant’s Signature Social Security #:________________________Date of Birth: _______________Phone:_________________ Current Address: ________________________________City: _____________State:________Zip:_______ ________________________________________ __________________________________ Guarantor’s Name (print) Guarantor’s Signature Social Security #:________________________Date of Birth: _______________Phone:_________________ Current Address: ________________________________City: ______________State:________Zip:_______ Authorization for Electronic Debit: You are hereby on notice that all checks submitted to this office can be processed electronically, at first presentment, and any re-presentments, by transmitting the amount of the check, routing number, account number and check serial number of your financial institution. By submitting a check for payment, you are authorizing us to initiate an electronic debit from your bank or asset account as early as the same day the check is received in our office. Please note that you will not receive a cancelled check with your bank or asset account statement with respect to any checks processed electronically, but such amounts will appear as debits on the statement issued by your bank or asset account.