Rent Increase Request Form - Fort Worth Housing Solutions

In order to process your Rent Increase this form must be filled out in its entirety and sent to
the Inspection Department at rentincrease@fwhs.org or fax to (817) 333‐3550 at least 60
days prior to the anniversary date.

Date *

Apartment or Owner Name *

Address of Unit

Apt #

Zip Code

Number of Bedrooms *

Number of Baths *

Sq Feet

Year Built *

Client Name *

Client Number

Current Unit Contract Rent

Requested Unit Rent

This portion Must be filled out.
Please specify the appliances:

Cooking

Gas

Electric

Heating

Gas

Electric

Water Heater

Yes

No

If Yes:

Gas

Electric

Tenant CURRENTLY PAYS: (Check all that apply)

CHANGE to tenant pays: (Check all that apply)

Owners Certifications: A. The program regulation requires the PHA to certify that the rent charged to the housing choice voucher tenant is not more than the rent charged for other unassisted comparable units. Owners of project with more than 4 units MUST complete the following section for most recently leased comparable unassisted units within the premises.

Unit 1: Address and unit number

Unit 1: Date Rented

Unit 1: Rental Amount

Unit 2: Address and unit number

Unit 2: Date Rented

Unit 2: Rental Amount

Unit 3: Address and unit number

Unit 3: Date Rented

Unit 3: Rental Amount

A rent reasonable survey will be conducted to ensure the rent amount approved is in accordance to HUD regulations. If the rent is not rent reasonable, a denial letter will be sent to the landlord and client.

Note: The client may relocate at their anniversary date if proper notice is given to the landlord and FWHS. If the new rent amount creates a burden to the client, the client has the right to give the landlord proper notice to relocate. Effective date of the increase will be either the anniversary date or 60 days after the 1st of the month following the receipt of the increase request. The client may contact the counselor if there are any questions.

Signature *

Date *