Housing Choice Partners HCV Discrimination Form

Housing Choice Voucher Discrimination Form
When trying to rent a home using your Housing Choice Voucher in Chicago or Cook County, have you been told...

“We don’t take the voucher.”
“Two years of steady employment is required to rent.”
“Your income must be 3x the total rent to live here.”
“Don’t apply if you don’t have a job.”
“You have to have a 750 credit score to rent.”

Has a landlord or housing provider in Chicago orCook County done any of the following becauseyou have a voucher?
Refused to show you a property
Refused to take part in a rental inspection
Stopped communicating with you
Stalled processing paperwork

If so, fill out this brief form. Someone will be in touch with you as soon as possible.
Date*

MonthDayYear
Date
Name*

Your First NameYour Last Name
Your Phone*
Your Email*
example@example.com
Mobility Case Manager*
Address of Unit You Were Interested In
Company Name (If Known)
Name of Person You Spoke to
Phone # of Person You Spoke to
Email of Person You Spoke to
example@example.com
Communication type used to contact housing provider:

PhoneFace to FaceEmailText
Date of Conversation

MonthDayYear
Date
How did you learn about the unit (Online Ad (i.e., Redfin, Trulia), Newspaper Ad (i.e., Chicago Tribune, etc.), Word of Mouth, etc.)*
What Was Said (please give as much detail as possible below):*
Are you still interested in renting this unit?*

YesNo
Would you like to be contacted to learn about filing a formal complaint?*

YesNo
Reminder:

Retain all emails, text messages, call history, and voicemails. If you have additional information, please provide that to the housing counselor when you speak with them. Keep a copy of the advertisement. (If online, be sure to print a copy.)
Should be Empty:

Housing Choice Voucher Discrimination Form

Reminder: