RESPONSE TO NOTICE OF RESIDENT CONCERN

PROPERTY NAME

GA ID NUMBER OF THE PROPERTY

MANAGEMENT COMPANY NAME

I AM:

IS THE OWNER AWARE OF THE TENANT NOTICE OF CONCERN

Other

Name

First NameLast Name

Email

example@example.com

Phone Number

Area CodePhone Number

BRIEF DESCRIPTION OF THE TENANT CONCERN

HAS THIS TYPE OR A SIMILAR TYPE OF TENANT CONCERN BEEN BROUGHT TO YOUR ATTENTION BY DCA WITHIN THE LAST YEAR?

PLEASE EXPLAIN THE NATURE AND DATE(S) OF THE PREVIOUS CONCERN AND INCLUDE THE RESOLUTION (OR THE REASON THAT THE PREVIOUS CONCERN REMAINS OPEN AT THIS TIME)

Please include tenant names and corresponding unit numbers, if applicable

DOES THIS MATTER CONCERN A RENT INCREASE?

DOES THE RENT INCREASE EXCEED 5% OF THE TENANT'S CURRENT NET RENT?

HAVE YOU PROVIDED THE TENANT WITH 120 DAYS WRITTEN NOTICE OF THE PROPOSED RENT INCREASE, TO INCLUDE THE OPTION FOR THE TENANT TO TERMINATE THE LEASE PRIOR TO THE START OF THE NEW RENT INCREASE, WITH NO PENALTIES OR FEES RELATED TO SUCH A TERMINATION OR NON-RENEWAL?

For more information regarding our new Rent Increase policy, visit the Rent Limits page on our website.

ENTER YOUR TENANT'S UNIT ADDRESS

ENTER YOUR TENANT'S CURRENT NET RENT

ENTER YOUR TENANT'S PROPOSED NET RENT

HAS THIS MATTER BEEN RESOLVED?

WHAT IS THE STATUS OF THE MATTER TODAY:

PLEASE STATE THE ACTIONS TAKEN TO RESOLVE THIS MATTER

HAS THIS MATTER RESULTED IN A CASUALTY LOSS?

All Casualty Losses should be reported to the DCA here, using our online reporting system.

LIST THE DATE OF YOU (OR YOUR AGENT'S) LAST COMMUNICATION WITH THE TENANT

Date

LIST THE NAME OF THE PERSON YOU CORRESPONDED WITH

First NameLast Name

LIST THE PHONE NUMBER OF THE PERSON YOU CORRESPONDED WITH

Area CodePhone Number

LIST THE EMAIL OF THE PERSON YOU CORRESPONDED WITH

BRIEFLY DESCRIBE WHAT YOU DISCUSSED WITH THE TENANT (or attach the correspondence below and type "see attached" in this field to continue)

I CONSIDER THIS MATTER TO BE:

Other

If this matter is pending, please list the steps needed to resolve this matter

Please state the date you intend to resolve this matter (the DCA will use this date for purpose of follow up and confirmation of resolution)

Date

Please state the reasons you are disputing this as a valid tenant concern

ATTACH ANY SUPPORTING DOCUMENTATION HERE (email correspondence, pictures, invoices, notices sent, etc.)

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By clicking "Submit" below you do affirm that you are the Owner of the Property in this matter, or an authorized agent responding on behalf of the Owner. You agree that the act of knowlingly submitting any false or misleading claims, responses, or documents, to the DCA may result in a finding of non-compliance and/or any other program violation.