Application

Username: tammybrooks1

NOP And Disclaimer

I have read the
Disclaimer: Yes

Circumstance
Reduction in work
Loss of employment: Yes hours: Yes
Reduction in income/
Furlough from salary due to reduced
employment: No business revenue: No
Has anyone in the
household been
unemployed for 90
days or more due to
COVID-19?: Yes Rent: Yes
Receiving Fixed
Eviction Notice: Yes Income: No
Has rent increased: No Middle name:
Assistance Needed for
Utilities: No rent : 16,650.00
Gas Deposit/Reconnect
Gas: No Fees: No
Electric Deposit/
Electric: No Reconnect Fees: No
Water (For North Las
Vegas residents only,
this includes water,
Sewage: No garbage and sewer.) : No
Trash (Only applicable
Water Deposit/ to bills paid directly to
Reconnect Fees: No Republic Services): No
When were you first
impacted?: March 30, 2020 Rent From Date: July 1, 2021
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Circumstance
Rent To Date: April 1, 2022

Person
First Name: Tammy Middle Name:
Last Name: Brooks Gender: Female
What is the your
Date of Birth: February 1, 1968 preferred language?: English
Has this residence filed
Is your mailing address an Answer with the
the same as your Court to an Eviction
primary address?: Yes Notice?: No
North American
White/Caucasian: Yes Indian/Alaskan: No
Black/African Native Hawaiian or
American: No Other Pacific Islander: No
Asian: No Client Refused: No
Are you a U.S.
Ethnicity: Non-Hispanic Veteran?: No
Email address: tammylynnbrooks22@gmail.com Phone Number: 702-778-6743
Please check the
box for anyone who
is receiving or has
received any benefits: No

Residential Address
Street Number: 184 Street Direction:
Street Name: Timeless View Street Suffix: Court
Apt/Suite: City: Henderson
State: Nevada Zip: 89012-5568

Mailing Address
Street Number: 184 Street Direction:

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 Mailing Address
Street Name: Timeless View Street Suffix: Court
Apt/Suite: P.O. Box:
City: Henderson State: Nevada
Zip Code: 89012-5568

Veteran
Branch:

Employment
Employment Category: Employment Employer Name: Entact LLC
How much is this
person paid?(Gross -
Total with anything What type of
taken out such as taxes employment is this
or benefits.): 1,607.00 job?: Paid Employment
What is the current When did this person
employment status?: Full-Time start this job?: August 5, 2019
Street 1: 601 Abbot Road City: East Lansing
State: Michigan Zip Code: 48823
Is Self Attestation
Required?: No

Resources
What is the cash/
What is the type of market value of this
resource?: Checking Accounts resource?: 500.00

Submission
First Name: tammy Middle Name:
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Submission
Rights And
Last Name: brooks Responsibilities: Yes
Authorize Release
Information: Yes Applicant Signature: Yes
Self Attestation: Yes

Covid19ImpactSelfAttestation
First Name: tammy Middle Name:
Last Name: brooks Other's:
my work hours were
initially reduced before
I was laid off work.
then had increased
costs of spending on
transportation and food
delivery also purchasing
Covid Preventive
Equipments I was laid
off work which caused
my reduce in income
and have been served an
More Detail's: eviction notice Applicant Signature: Yes

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