Curs MD

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RENTAL/SUBLEASE APPLICATION

(Subtenant data form. Please fill in entries applicable to


you) (For Rental Purpose Only)

First Name: Ilie Eusebiu

Last Name: Dumitriu

Age: 24

Sex: M

Marital Status:
(single/married) Single

State any criminal


No
record:

Please fill out Co-Applicant Data below(if any)

First Name: Andreea Marinela

Last Name: Ghinuta

State relationship
Fiancee
with Co-applicant:

Pets (if any) fill below: No pets

Contract Details fill below

Phone: Mobile: Email: Fax:

0040755458699 seb_d16@yahoo.com

Select a discount option for One time


Payment

3 - 4 Months - 10% discount

5 - 8 Months - 15% discount

9 - 12 Months - 20% discount


Present St. Poetului no.1, Arad, Romania
Address / Location

Reason for
I am coming in New York for working at a dentistry office for a couple of months.
Searching for an
APT

24 june, after 10 pm.


Move in Date: Move out Date: 24 October
Because i am landing in NY
(please be specific) at 9 pm. (please be specific)

Expected Lease Duration: 4 months (Choice of Lease plan)

Do You Intend To Reserve this Unit Now


Yes
this Ensure that the unit is available on your move date:

Reserve payment Bank Deposit/Transfer


Method (Long Term /Short Term Rental)

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