Real Estate Tenant Hardship Questionnaire
Real Estate Tenant Hardship Questionnaire
This questionnaire is designed to assess the hardship circumstances of our tenants. Please complete all sections of this form with accurate and up-to-date information. Your responses will help us understand your situation better and determine the appropriate support or arrangements that can be made.
Tenant Information
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Information |
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Name: |
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Lease Start Date: |
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Property Address: |
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Contact Number: |
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Email Address: |
Current Employment Status
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Field |
Information |
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Employer Name: |
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Position: |
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Employment Status: |
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Date of Employment Start: |
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Date of Employment End (if applicable): |
Financial Information
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Field |
Information |
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Monthly Income Before Taxes: |
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Monthly Income After Taxes: |
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Other Income (Please specify sources): |
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Total Monthly Expenses: |
Hardship Information
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Field |
Information |
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Type of Hardship (e.g., unemployment, illness, reduced wages): |
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Date Hardship Began: |
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Is the hardship temporary or permanent? |
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Explanation of Hardship (Please provide a detailed explanation of your current circumstances): |
Assistance Requested
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What type of assistance are you seeking? (e.g., rent reduction, payment plan, lease termination) |
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How long do you anticipate needing this assistance? |
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Declaration
I/We hereby declare that the information provided above is true and accurate to the best of my/our knowledge. I/We understand that providing false information may result in the denial of assistance or other penalties.
[Date]
This questionnaire is provided by [Your Company Name] and is intended to assist in evaluating the tenant's request for hardship consideration. All information provided will be treated with confidentiality.
