Rent Increase Request-Notice Of Change Of Terms Of Tenancy-Form
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2HOUSING AUTHORITY OF THE COUNTY OF SAN BERNARDINO
Housing Choice Voucher Program-Inspection Unit
672 S Waterman Ave, San Bernardino, CA 92408
(909) 890-9533 – FAX (909) 890-5333
email:
RENT INCREASES
Rent increase requests are normally reviewed in conjunction with the annual inspection as the condition and
appearance of the property affects the rent evaluation. If you wish to request a rent increase or change any other
terms of tenancy, serve the tenant with notice using a copy of the enclosed form and return the form with the
completed and signed worksheet to our office. To provide comparative rental market data to support your
request, fill out Section 2 (optional). The Housing Authority will notify the tenant of any change in rent as it
affects them. You may provide this information via mail, fax or email (scan and attach) to the above address,
fax number or
. Incomplete requests will not be processed and will be returned to you
for completion.
LANDLORD RENT INCREASE WORKSHEET
1. Required information: Subject Unit address:_______________________________________________________
Type unit; Apartment ___ Single Fam Res ___
Number of bedrooms;____(must fill in)
Utilities & appliances provided as part of the rent;__________________Owner/Manager Name__________________
Mailing Address;____________________________________________________________________________
Telephone Number(s)_____________________
Email _____________________________________
Rent comparables are used to ensure that approved rents for subsidized units are reasonable in comparison to the rents for
unassisted units in the same area. To determine the approved rent, our inspectors will consider factors such as the size of the
unit (square feet), the unit type, quality, amenities, age, maintenance, and utilities.
2. Optional information: Provide three verifiable comparables for non-assisted units in your complex or in your neighborhood
that favorably compare to your unit (Providing this information is optional, but may help you to receive your asking rent).
UNIT 1
UNIT 2
UNIT 3
Comparable Property
Address
Contact phone number
Year Built
Number of Bedrooms
Number of Bathrooms
Square Feet
Current Rent
Do you own or manage
Yes ___ No ___
Yes ___ No ___
Yes ___ No ___
this unit?
AMENITIES (Yes or No):
Air Conditioning
Garage
Laundry Facility
Pool
Playground
Other
Other
3. Required information:
Attach a copy of completed “Notice to Tenant”.
4. Required information:
As the legal owner or authorized agent for the above listed property, I hereby request an
increase in the rental amount as follows;
$________
$
Current monthly rent amount;
New requested monthly rent amount;
___________
I hereby certify the information I have entered above is true and accurate to the best of my knowledge.
Print name ___________________________________ Signature & date ______________________________________
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