Landlord Rent Increase Form

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OWNER’S REQUEST FOR RENT INCREASE
Today’s Date:__________________________
Owner’s Name:________________________ Tenant’s Name: __________________________
Owner’s Address_______________________ Tenant’s Address__________________________
____________________________________
_______________________________________
___________________________________
________________________________________
Current Rent: $____________ Requested Rent:$__________ Effective Date:_______________
Reason for rent increase:_________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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Owner’s Signature:____________________________________________
Please return this form to us by mail or fax. We must receive this form no later than sixty (60)
days before the annual re-certification of the tenant for the request to be considered. Please
note that your request will be denied if the Authority determines that the requested rent is not
reasonable in relation to rents charged for comparable unassisted rental units. If you have any
questions concerning this matter please contact our office.

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