[NOTE: The following sample questionnaire is used with the New York Store Lease Riders Library. If you ordered the library for some other jurisdiction, some of the questions and terms would be different.]


Identify landlord -

__male __female __corporation __partnership __LLC
Identify tenant -

__male __female __corporation __partnership __LLC

Any guarantor(s) of tenant's obligations -

__male __female __corporation __partnership __LLC
Identify any broker(s) who brought about lease -

__male __female __corporation __partnership __LLC
commission to be paid by: __landlord __tenant
Identify the premises -
Str. Addr.:
Common name of building:
Description of premises:

Date of lease:
__lease term to commence on subsequent date:
Term of lease:
__tenant may extend lease term - describe the options, advance notice, new rent, etc.:

__a security deposit: $

__tenant to accept premises "AS IS"
__landlord is to perform work:
to be paid by:
__landlord except tenant pays $
__landlord except tenant pays ___%
__to be completed before commencement date
__to be completed before:
__tenant to pay __all or ___% of change orders
__tenant is to perform work:
to be paid by:
__landlord except tenant pays $
__landlord except tenant pays ___%
__to be completed before commencement date
__to be completed before:
__tenant to submit architect's drawings - Architect:
__tenant to get permits or govt. approvals
__tenant to provide performance bond
__landlord not to unreasonably withhold consent to alterations
__tenant may make alterations if cost under $
__tenant must use approved office cleaning company
__tenant must exterminate vermin using approved exterminator
__tenant must employ its own waste removal service
If window glass is broken:
__tenant shall replace
__landlord shall replace (unless tenant at fault)
__lease is to be silent on the subject
__tenant to maintain a sprinkler system
__tenant to maintain licenses and permits:

__provisions for fixed rent are to be the RIDER (not just on the printed form)
Fixed rent is to be paid:
__calendar quarterly
__other quarterly:
__annually, each January 1st
__annually, on other day:
Enter the fixed rent, at the annual and monthly (or other periodic) rates (and if it changes on specific dates, enter the dates and new rates):

__first installment of rent to be paid upon lease execution

If tenant fails to pay rent when due:
__tenant to pay a late charge - ___% of amount owed
__tenant to pay interest: ___% per annum
__any grace period for additional rent: ___ days
__any grace period for fixed rent: ___ days
__tenant to pay Percentage Rent
Percentage:___% of
__gross receipts
__gross receipts less operating expenses
__gross receipts less operating expenses & $________
__gross receipts less operating expenses & fixed rent
__gross receipts less $________
__gross receipts less fixed rent
__tenant is to pay escalations based on increases in -
__real estate taxes
__building operating expenses
__energy costs for the building - ___% of landlord's bill
__porter wage rate
Sq. ft.in premises:
"MULTIPLIER" (e.g., 2.0):
Labor contract to be used:
Date of base wage rate:
__consumer price index
"Escalation Year" ends on:
"Escalation Year" for other escalations to end on:
"Base Year" for real estate tax escalations:
"Base Year" for other escalations:
"Tenant's Share" of escalations is to be:
__a percentage: ___%
__a formula - sq.ft. of premises/space in building
Escalations to be paid: __monthly __quarterly __yearly
Escalations to commence:
__first Escalation Year based on estimates
__first Escalation Year based on a presumed percentage increase over Base Year: ___%
__when landlord renders a statement
__landlord will contest real estate taxes if tenants occupying ___% of building so request (and agree to pay share of costs)
__disputes re escalations to be resolved by arbitration
__electricity to be provided on a "rent inclusion basis"
__cost of electricity is to be added to fixed rent (i.e., not already included in the amount of rent)
__amount is to be adjusted if consultant determines that actual use differs from $
__tenant may install air conditioning
__landlord to provide air conditioning
__from 8:00 AM to 6:00 PM
__landlord to provide air conditioning after normal hours if tenant pays charges
Charges for air conditioning:
Charges for heating:
Charges for ventilation:
__tenant to pay water meter charges [__meter to be installed]
__tenant to pay a portion of water charges for building: ___%

__tenant to maintain liability insurance:
__$3,000,000/person $5,000,000/accident $1,000,000/property
__$1,000,000/person $3,000,000/accident $500,000/property
__$1,000,000/person $2,000,000/accident $300,000/property

__tenant also to maintain "rent insurance"
Do you want a short form of lease? __Y __N

__tenant to license basement space for storage:

__lease to restrict type of business conducted at premises:

__landlord not to unreasonably withhold consent to other uses
__closing business for ___ days to constitute a default
__prohibit loudspeakers, music and similar noises
__prohibit auction, fire and bankruptcy sales
__restrict installation of heavy equipment
__restrictions on signs and exterior installations [__drawings of proposed signs have been approved]
__prohibit violation of certificate of occupancy
__tenant not to violate specific instruments of record:

Does printed form prohibit assignment without landlord's consent? __Y __N

__prohibit transfer of majority interest in partnership or corporation
__tenant may assign to an affiliate
__landlord's not to unreasonably withhold consent to:
__partial subletting
__subletting of entire premises
If tenant requests consent, landlord shall be paid:
__expenses including reasonable attorneys' fees
__processing fee $
__processing fee equal to ___% of rent
__if tenant requests assignment or subletting, landlord may terminate lease [elect within how many days: ____ / termination to take effect not more than ___ days or less than ___ days]
__if subrent under a sublease exceeds the rent under lease, landlord may increase rent by ___% of such excess
Is lease to give tenant -
__a right of first refusal to lease additional space
__an option to lease additional space
Describe additional space:

option to be exercised -
__prior to a specific date:
__subsequent to a specific date:
__at any time
If option is exercised, rent is to be increased -
__in proportion to increase in sq. ft.
__tenant to have the right to cancel lease (__with or __without a cancellation charge) within an initial period of lease term - describe charge, period, notice requirements, etc.:

__landlord's liability limited to the building
__tenant's liability limited to interest in premises
__tenant to deliver estoppel letters
__landlord to deliver estoppel letters
__tenant will modify lease as reasonably requested by landlord's institutional lender
__lease is a sublease - identify paramount lease:
__tenant to pay attorneys' fees incurred in enforcing lease
__prohibit recording lease
__prepare acknowledgments

Enter number of last article of printed form: