Application For A Rent Reduction Based Upon Decreased Service
ADVERTISEMENT
1
2Docket Number:
State of New York
Division of Housing and Community Renewal
Office of Rent Administration
Web Site:
Application For A Rent Reduction
Based Upon Decreased Service(s) - Individual Apartment
1. Mailing Address of Tenant:
2. Mailing Address of Owner:
Name:
Name:
Number/Street:
Apt. No.:
Number/Street:
City,
City,
State, Zip Code:
State, Zip Code:
Telephone No.: Bus. (
)
Telephone No.: (
)
Res. (
)
3. Subject Building (if different from tenant's mailing address):
Number and Street
Apartment Number
City, State, Zip Code
Instructions To Tenant:
Before filing this application, you should first notify the owner or agent in writing of all the service
decreases in this application. You should attach a copy of your letter and proof of delivery to the owner or agent. If you do not
send a letter to the owner or agent and attach a copy with proof of mailing, the owner/agent will be given additional time to respond
to your complaint.
Use this form if you want to report a decrease in services in your individual apartment which you have not already reported to us. If
you want to report a decrease in building-wide services, please use Form RA-84. To complain about a lack of heat or hot water, use
Form HHW-1. Both forms are available at the Rent Office at Gertz Plaza or your District/Borough Rent Office.
Mail or deliver the original plus one copy of the signed form and one copy of all attachments, to the Rent Office listed on the reverse side
of this form. Keep one copy for your records.
Part I - General Information
1. My apartment is:
Rent Stabilized
Rent Controlled
Hotel Stabilized
SRO (Single Room Occupancy)
a.
A Co-op/Condo (Complete the following):
Unit Owner/Proprietary Lessee:
Name of Cooperative Corp./Condo Assn.:
Managing Agent:
b.
My building is managed by a 7a Administrator:
(Name of 7a Administrator)
2. I moved into my apartment on _____/_____/_____.
3. The total number of apartments in this building is:
Date
(a) I have SCRIE or DRIE.
Yes
No
(b) Section 8 Program:
None
U.S. Dept. of Housing & Urban Development
N.Y. C. Housing Authority
Housing Choice Voucher
N.Y. C. Dept. of Housing & Preservation Development
If applicable, enter Certificate/Voucher Number: ________________________________
(SEE REVERSE SIDE)
RA-81 (3/14)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal