Fillable Printable Rent Increase/Decrease Request Form - New York
Fillable Printable Rent Increase/Decrease Request Form - New York
Rent Increase/Decrease Request Form - New York
VICKI BEEN
Commissioner
LAURIE LoPRIMO
Assistant Commissioner
Office of Financial Management
and Analysis
Division of Tenant Resources
100 Gold Street
New York, N.Y. 10038
Rent Reasonableness Policy Per federal regulation 24 CFR 574.320 (a)(3), HPD will conduct a test to determine if
the rent you are requesting is reasonable. The rent charged for a Section 8 assisted unit must be reasonable in relation
to rents currently being charged for comparable units in the private unassisted market and must not be in excess of
rents currently being charged by the owner for comparable unassisted units.
Rent Request Information
PART I: LANDLORD/ AGENT INFORMATION PART II: TENANT INFORMATION
1.OWNER________________________________
2. TENANT___________________________________
MANAGING
AGENT__________________________________
SSN__________________________________________
ADDRESS________________________________
______________________________________
ADDRESS____________________________________
_________________________APT.#_______________
PHONE NO. ______________________________
PHONE NO. __________________________________
EMAIL
ADDRESS:_______________________________
PART II: RENT INCREASE/DECREASE INFORMATION
3. CURRENT RENT
CHARGED TO FAMILY
4. AMOUNT RENT
CHANGE REQUESTED
5. NEW RENT REQUESTED
RENT (3 + 4)
6. EFFECTIVE
(month/ day/ year)
7. TYPE OF UNIT (please check all that apply)
Rent Stabilized
Project Based Voucher (PBV)
Co-op
Mitchell Lama
J-51
421-a
LAMP
MIRP
HOME
LIHTC
Section 236
Other:
8. REASON FOR INCREASE (please check)
NOTE: You must attach all required documents to substantiate your request.
LEASE RENEWAL: TERM OF LEASE
from to
MAJOR CAPTIAL IMPROVEMENT (MCI)
MAXIMUM COLLECTIBLE RENT (MCR)
OTHER
APPLIANCE/ INDIVIDUAL
APARTMENT IMPROVEMENT
FUEL COST PASS THRU
MAINTENANCE INCREASE
(CO-OP ONLY)
HPD RENT RESTRUCTURING
SECTION 236 RENT ORDER
MITCHELL LAMA RENT ORDER
ARTICLE 8A ADJUSTMENT
Please return your request via mail or in
person to:
HPD Division of Tenant Resources
ATTN: Rent Approval Unit
100 Gold Street, Room 1-0 New York, NY
10038
Questions regarding this form, call the Rent
Approval Unit at (917)-286-4300
Directions: Please complete this form and the attached Rent
Comparable Form. The Rent Comparable Form on page 2
must be completed with the Section 8 unit information even
if you are not supplying HPD with information on
comparable unassisted units.
Any applicable documentation supporting your proposed rent
request must be attached with the completed forms.
Incomplete requests will be rejected.
Please Note:
This Rent Increase Request form must be submitted at least sixty (60) days prior to the effective date of the
rent increase. Late requests may result in a loss of subsidy payment.
The Participant’s share of the rent does not change unless an updated Rent Breakdown Letter has been
issued by HPD.
Rent Increase/Decrease Request Form
PART III: Rent Reasonableness: Unit & Comparable Unit Information (continued, Page 2)
PART III: Rent Reasonableness: Unit & Comparable Unit Information
DIRECTIONS:
Please enter the requested information for the proposed unit below. If you would like to submit
additional information on three unassisted comparable units that support your requested rent, please complete the
optional columns. HPD will only consider information on units within the immediate neighborhood and rental market.
PART IV: LANDLORD CERTIFICATION AND ACKNOWLEDGEMENT
I, ,
LANDLORD/MANAGING AGENT,
certify that the information that I have provided for HPD’s consideration is true and correct to the best of
my knowledge.
understand that I may not charge rent for a Section 8 assisted unit that is in excess of rents currently being
charged for comparable unassisted units (the only units considered assisted have a government subsidy,
everything else is considered unassisted) within my building.
certify that the Housing Choice Voucher lease addendum or occupancy agreement executed between the
tenant and me as owner / managing agent remains in effect.
understand that if this increase is approved and executed it will serve to amend the Housing Assistance
Payment (HAP) Contract.
understand that if the rent requested is rejected by HPD I must amend the lease to reflect the reasonable
rent.
understand that I may not charge the tenant for a rent amount not approved by HPD.
_______________________________________ ________________________
Signature of Owner/ Managing Agent Date
Unit Information REQUIRED
Proposed Unit
Unit #1 (optional) Unit#2 (optional) Unit #3 (optional)
Unit Address/ Apt. #
(specific address required)
Square feet
No. of bedrooms
No. of bathrooms
Unit Condition
1. Very good = New or full
renovation (must include
kitchen & bath ) in the past 5
years
2. Good= Well maintained
or Partial renovation
(upgrades to 1+ room(s) in
the past 5 years
3. Average= No work in the
past 5 years
Very good
Good
Average
Very good
Good
Average
Don’t know
Very good
Good
Average
Don’t know
Very good
Good
Average
Don’t know
Utilities included in rent:
Please describe (gas, electric,
oil)
Balcony (Y/N)
Y N Y N Y N Y
N
Amenities
Wheel chair
accessible
Onsite laundry
Onsite super
Wheel chair
accessible
Onsite laundry
Onsite super
Wheel chair
accessible
Onsite laundry
Onsite super
Wheel chair
accessible
Onsite laundry
Onsite super
Other amenities, if any
Monthly rent
$ $ $ $
