Leasing Leasing Information Glenn Fox glennf@gumberg.com Gumberg Asset Management Corp. 3200 North Federal Highway Fort Lauderdale, FL 33306-1033 Leasing Office: 954-537-2700 Temporary Leasing Tenant Application Thank you for your interest in Country Club Mall! Please provide the following information. Upon receipt, we will review your information and contact you, generally within 24 hours. Please note that items with an asterisk are required fields and must be completed prior to processing this form. Tenant Profile Name:* Name of Business:* Address:* Email:* Telephone:* Home Telephone: Fax Number: Best Time To Be Reached:     Company Profile Business Type:* Existing Stores: Please list name and locations of existing locations:   Are these stores owned or franchised? OWNED FRANCHISED   Can you provide pictures of these locations? YES NO   Can you supply us with references? YES NO   Will you operate your store or hire a manager? OPERATE HIRE A MANAGER     Product Information Square Footage: What type of square footage do you need? Product Range: What is your range of products? Price Points: What are your price points? Current Concept: What is your current concept and how will you tailor that concept for Country Club Mall? Customer: Who is your customer? Marketing Plans: What plans do you have to market and promote your business?     Financial Information Projected Volume: What type of volume would you project you could do yearly at Country Club Mall? Average Sales: What are your average monthly sales?

Country Club Mall • 1262 Vocke Road • LaVale, Maryland • 301.729.8002 © 2017 Gumberg Asset Management Corp. • Privacy Policy • Site Map