You are associated to a lease that either requires an Early Out Notification within the next 90 days or has
a Lease End Date within the next 90 days.

Please complete the survey below to inform Accounting and Branch Operations of your intentions to
renew or end this lease. If you do not respond within 7 days, this survey will be sent again. Failure to
submit this form in a timely manner will result in a hold on all future rent payments for your branch
once the lease has lapsed.

The Accounting Department wants to ensure that the day-to-day operations
at your branch are not interrupted by notices from landlords or late rent payments. If you have
questions, please contact rentinvoices@ccm.com.

The person completing this survey should enter their own first and last name below.

Question Title

* 1. First Name

Question Title

* 2. Last Name

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