HomeMy WebLinkAboutExhibit E Annual Tenant Housing Report FormAnnual Tenant Housing Report Form – Due January 30th for preceding calendar year Exhibit E
Name, Phone Number & Email of Person Completing Form:
Property Address: Period Covered:
January 1, 20___to December 31, 20___
Property Owner: Required Number of Units per Ordinance:
Unit #
# of
Bdrms
Last Name or Client ID# Total
Monthly
Rent
(
Annual
Income Below
60% AMI
(Y/N)
Size of Household
(all members)
Start/Renewal of Lease Lease Expiration Date
.
I certify that the information above is, to the best of my knowledge and belief, true, correct and complete. I am aware that the information being provided is subject to verification by
the City of Iowa City.
__________________________________ ________________________________________ __________________
Name (print)Signature Date
Complete and return to:
neighborhoods@iowa-city.org
City of Iowa City, Neighborhood Services
410 E. Washington Street
Iowa City, IA 52240
If you have questions, please call 319.356.5230