Landlord Questionaire

Please answer the following questions regarding you and your rental property and return to Partners for Community Development, Inc. along with a COPY of one of the following: Current year Property Tax Bill, Registered of Deed, Registered Land Contract, or Registered Life Estate.
Fields with * are required fields.

Please fill in all applicable field(s) to you regarding your property below:
Company Name (if applicable):
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Enter your full name:*:
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Enter your address:*:
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City:*:
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State:*:
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Zipcode:*:
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Enter your phone:*:
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Phone type:
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Secondary Phone:
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Phone type:
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Email Address:*:
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What year was the property built?
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What is the primary heating system?*:
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Primary heating system other:
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Has the heating system ever been replaced?*:
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If Yes, When?
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Are any utilities included in the rental payment?
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Has the owner been found eligible for Energy Assistance within the past year?
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* If no, the property owner is required to contribute 20% of the total cost of weatherization work performed. *
Property owners are responsible for signing off on the work done through the weatherization program. If you will be designating a property manager to sign off on your behalf please list his/her name and title below:
Signing off completion work person's name and title:
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How many living units does your rental property has?
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Unit 1:
Enter renter's full name:
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Enter Renter's Address:
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Enter Renter's City/State/Zipcode:
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Enter Renter's Phone:
Invalid Input! Enter phone including area code (123-456-7890).

Enter Renter's rent amount:
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Enter Renter's # of household members:
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Unit 2: (if applicable)
Enter unit 2 renter's full name:
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Enter unit 2 renters address:
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Enter unit 2 renter's City/State/Zipcode:
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Enter unit 2 renter's phone:
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Enter unit 2 renter's rent amount:
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Enter unit 2 renter's # of household members:
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** If additional space is needed, please attach another sheet of paper **
For 3 or more units, upload additional renter(s) information here:
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** In order to prevent spam submission of this form, please enter the code you see below into the space provided below. **
Your anti-spam code:*:
Your anti-spam code:
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