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* 1. Property Owner Information:

Please complete the following information effective November 1, 2015

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* 2. Property #1 Address:

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* 5. Was the unit vacant on November 1, 2015?

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* 6. What was the rent on November 1, 2015?

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* 7. Is the unit being rented by a family member?

Second Unit (Duplex only)

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* 9. Was the unit vacant on November 1, 2015?

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* 10. What was the rent on November 1, 2015?

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* 11. Is the unit being rented by a family member?

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* 12. Do you have another property?

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