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Legislative Session Rental Housing Information Survey

Legislative Session Rental Housing Information Survey

Please describe the rental space you have available. Contact Sarah Wirfs (Sarah.Wirfs@oregonlegislature.gov ) with any questions you may have.

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* 1. Date rental is available:

Date Available:

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* 2. Type of Rental:

Apartment

House

Duplex

Condo

Mobile Home

Room Only

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* 3. If room only:

Kitchen Privileges

Private Bath

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* 4. Is the space furnished:

Yes

No

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* 5. Garage:

Yes

No

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* 6. Carport

Yes

No

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* 7. # of Bedrooms:

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* 8. # of Bathrooms:

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* 9. Pets okay?

Yes

No

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* 10. Utilities Included:

Water

Gas

Heat

Cable TV

Electricity

Phone

Wash/Dryer

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* 11. Rental Address:

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* 12. Monthly Rent: ($)

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* 13. Deposit Required: ($)

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* 14. Contact Name:

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* 15. Email Address:

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* 16. Home Phone Number:

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* 17. Work Phone Number:

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* 18. Cell Phone Number:

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* 19. Comments:

*The anticipated need for housing will be during Session only.