Form Rr-1 - Initial Apartment Registration
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1
2State of New York ● Division of Housing and Community Renewal
Processing Services Unit, Hampton Plaza,
38-40 State Street, Albany, NY 12207 Visit DHCR website at:
INITIAL APARTMENT REGISTRATION
NOTE: All information entered on this form must be valid for the date this apartment became subject to Rent Stabilization (this is the date entered in Item 1)
Date apartment became
2. Date of this Initial Registration
1.
14. Legal Regulated Rent on Date in Item 1
subject to Rent Stabilization
$
per
Month
Week
________/________/________
________/________/________
15a. Actual Rent Paid on Date in Item 1 (enter only if different than
Month
Day
Year
Month
Day
Year
Legal Regulated Rent in item 14 above)
MDR
ETPA
Hotel
3. Building ID Number
$______________________________ per
Month
Week
4. Street Address
15b. Reason for difference:
Appliance Surcharge
DHCR Rent Reduction Order
Preferential Rent
Section 8
SCRIE/DRIE
5. City, Town or Village
6. Zip Code
NY
Other (specify):__________________________________________
7. County
8. Apartment Number
9. Total # of
16a. Reason for Initial Apartment Registration(check one)
Rooms
New Construction
Major Rehab
Late Registration
in Apt.
10. Tenant Name(s)
Apartment Vacant at time of previous Initial Registration
LAST
FIRST
M.I.
Apartment Previously under Mitchell-Lama
Apartment Previously Rent Controlled
$_____________ $_____________$_____________
Rent
MCR
MBR
11. Lease Dates in effect on Date in Item 1 above
Date Rent Controlled tenant vacated _______/_______/_______
Began on ______/______/______ Expires on ______/______/______
Month
Day
Year
Month
Day
Year
Month
Day
Year
Other (specify):_________________________________________
12. Equipment and services included in rent
(check as many as apply)
-----------------------------------------------------------------------------------------------
16b. Initial Apartment Registration Status
Stove
Refrigerator
Dishwasher
Blinds/Shades
Rent Control
Vacant but Previously Rent Stabilized
Furniture
Maid Service
Linen Service
Stabilized/ETPA
Room A/C (
) _______
No. of units
421-a Market Rate Unit
Other (specify): _________________________________________
421-a Income Restricted Unit
________% Area Median Income
13. Equipment and services for which a separate charge is
This 421-a Income Restricted Unit is reserved for individuals or families
collected by owner (check as many as apply)
whose incomes at the time of initial occupancy do not exceed the above
% of the area median incomes, as adjusted for family size.
Electricity/AC
Maid Service
Linen Service
Furniture
Master TV Antenna
Recreational Facilities
Exempt
(if exempt box is checked, one reason MUST be selected below):
Garage/Parking $__________________per month each car
Commercial/Professional
Owner Occupied/Employee
Separate Lease: From _____/_____/_____
To _____/_____/_____
Not Prime Residence/
High Rent, Vacancy Deregulation
Month Day
Year
Month Day Year
Not for Profit
Coop/Condo Occupied by Owner or Non-Protected Tenant
Other (specify): _________________________________________
Expiration of:
Section 11-243
Section 421-a
Section 608
or 11-244 (J51)
Owner
Managing Agent
Coop/Condo Owner
17. Owner/Managing Agent (check one)
LAST NAME
FIRST NAME
M.I.
NOTE: If unit is
coop/condo, enter
information for unit
owner. In all other
Street Address
Apartment/Room Number
cases, enter information
for building owner or
building managing
City, Town or Village
State
Zip Code
agent.
PARA INFORMACION EN ESPANOL, VEA RESPALDO DE ESTA FORMA.
IMPORTANT TENANT INFORMATION ON OTHER SIDE OF FORM
RR-1(i) 12/07
Copy 1 – DHCR
Copy 2 – OWNER
Copy 3 – TENANT (save for your records)
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