Eviction Extension Application Live

Eviction Extension Application
We need this information to delay your eviction. Typical evictions are delayed ~45-90 days

Please fill out fully.Upload a picture of your court document to skip a lot of questions
Legal Name *
Phone Number *
My Email Address *
example@example.com
How did you hear about us? *

Facebook/Instagram Google Mailer Other
Do you have a current Eviction case?
Take a photo of your court summons
Upload a copy of your court summons. (Recommended)

Cancel of
Street Address *
Zip code *
City *
County *
State
Birthday Day
1,22, 30 ect
Birthday Month
January, February...
Birthday Year
1955,1990...
Landlord Info
Landlord Name
Landlord Street Address
Landlord City
Landlord state
Landlord Zip code
Landlord Phone Number
Landlord Email Address
example@example.com
Current Month
Current Day (1, 19 , 20, ect)
Have you applied for Texas Rental Relief?

Yes No I've applied for other programs Yes, and I've applied to other programs
Have you been approved for rental relief or still pending?

Approved Paid Have already paid out Landlord refusing payment
What county is the eviction filed?
Case #
Precinct
Place
Court Number
ie: 4
JP County Court Date

Month Day Year
Date
Any Court Documents (or email to info@stayhousedtx.com)

Cancel of
Court Time

Hour Minutes

AM/PM Option
Why are you being evicted?
Why are you being evicted? *

Behind on rent Lease is over Lease Violations Other
In order to file an appeal the court requires some financial information. Do you wish to provide that now?
This information is needed by the court to try to lower/waive bond/rent payments

It is important to fill out completely
Do you have any children or dependents?
1st Dependent
Age Dependent 1
Relationship 1
2nd Dependent
Age Dependent 2
Relationship 2
3rd Dependent
Age Dependent 3
Relationship 3
4th Dependent
Age Dependent 4
Relationship4
Do you receive any public benefits?

I DO receive the following public benefits. No
Which benefits do you receive?

Food Stamps/SNAP TANF Medicaid CHIP SSI WIC AABD Public Housing or Section 8 Housing Low-Income Energy Assistance Emergency Assistance Telephone Lifeline Community Care via DADS LIS in Medicare (“Extra Help”) Needs-based VA Pension Child Care Assistance under Child Care and Development Block Grant County Assistance, County Health Care, or General Assistance (GA) Other
Total Amount of Public Benefits
Job Title
Employer
Monthly Wages
Unemployed Since

Month Day Year
Date
I receive unemployment in the amount of
Others in my household contribute
Other Public Benefits
Spousal Support / Child Support
Which Bank do you use?
Bank Account Value 1
Cash
Vehicle Year
Vehicle Make
Monthly Income Total
Vehicle Model
Value of Vehicle
Do you own any other property? Please list
Stocks, Other land, ect
Total Value of Any other Property
Total Assets
What are your monthly expenses?
Rent/House Payments
Food and Household Supplies
Clothing and Laundry
Utilities and Phone Bill
Medical/Dental
Insurance (Auto,Life,Medical,etc.)
School/Childcare
Transportation (auto,bus,uber,etc.)
Child / spousal support
Wages withheld by Court Order
Debt Payments Amount
Debt Payments to who?
Debt Payments to who? 2
Debt Payments amount 2
Total Expenses
Today's Date

Month Day Year
Date
By Signing Below, I Authorize Eviction Shield, LLC and subsidiaries To Use An Electronic Signature On Any Documents I Select For Submission To Any Court or Landlord. In additon, I agree to receive e mails, SMS & MMS notifications as well as telephonic notifications as Eviction Shield LCC and subsidiaries deems necessary for your account.
I declare under penalty of perjury that the information provided here is true and correct. In addition, you understand that the data you have provided will be used on forms designed by the Texas Supreme Court. These forms will be filed by us or by you in the appropriate JP Court. If your information is incorrect we have no control whether the court will accept your affidavit. By clicking the submit button you agree to take complete responsibility for the accuracy and the use of these forms. Further more, you understand that we cannot guarantee that the forms we produce will be applicable for your needs.

By clicking "submit" you agree to the use of an electronic signature and E-filing of your affidavit and
Print Full Name

First Name Middle Name Last Name
Signature

Clear
Our full filing package price is $250. Call for individual filing options

Discounts are available for referrals or those currently receiving SNAP benefits
Ready to pay?

Yes No
How would you like to pay?

Credit/Debit Cash App Venmo Other
Venmo (@EvictionHelp)
CashApp ($EvictionAdvocates)
By signing you acknowledge that any information provided does not, and is not intended to, constitute legal advice; instead, all information, content, and materials available on this site are for general informational purposes only.

You certify that all information provided is correct and Eviction Advocates will not be responsible for incorrect information that has been provided
Birth Date *

Month Day Year
Date
Signature *

Clear
After you submit you will be directed to our calendar. Please schedule a call if you have not spoken to a representative
Should be Empty:

Eviction Extension Application

We need this information to delay your eviction. Typical evictions are delayed ~45-90 days

Landlord Info

This information is needed by the court to try to lower/waive bond/rent payments

Our full filing package price is $250. Call for individual filing options

Venmo (@EvictionHelp)

CashApp ($EvictionAdvocates)

After you submit you will be directed to our calendar. Please schedule a call if you have not spoken to a representative