Housing Choice Voucher Program Inspection Checklist (Omb Approval No. 2577-0169) Page 7
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81.
Does the owner make repairs when asked? Yes
2.
How many people live there? _____
3.
How much money do you pay to the owner/agent for rent? $ ____________
4.
Do you pay for anything else? (specify) __________________________________________________________________
5.
Who owns the range and refrigerator? (insert O = Owner or T = Tenant) Range ______ Refrigerator _____ Microwave __
6.
Is there anything else you want to tell us? (specify) Yes
Page 7 of 8
Previous editions are obsolete
form HUD-52580 (3/2001)
ref Handbook 7420.8
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