RESPONSE TO NOTICE OF RESIDENT CONCERN

RESPONSE TO NOTICE OF RESIDENT CONCERN
PROPERTY NAME*
GA ID NUMBER OF THE PROPERTY*
MANAGEMENT COMPANY NAME*
I AM:*

The OwnerThe Property ManagerThe Regional ManagerCompliance Agent of the OwnerOther Agent of the OwnerOther
IS THE OWNER AWARE OF THE TENANT NOTICE OF CONCERN*

YESNOOther
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?*

YESNO
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?*

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

YESNO
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?

YESNO
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?*

YESNO
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?*

YESNO
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 *

MonthDayYear
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:*

Resolved / Close OutPending / I am actively working to resolve this or seek clarificationA Falsified ClaimOther
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)*

MonthDayYear
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.
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