90 DAY RENT INCREASE FORM
# Bedrooms: ______ # Bathrooms: ______ Current Rent: $___________
This Notice is to inform that there will an increase of $_______ for your monthly rent payment. The new monthly rent
amount will be $_______ in total and will be effective from this date _______/_______/_______.
Request must be a minimum of 90 days from the 1st of the following month. Example: Requested date October 15,
minimum effective date February 1.
Who pays for the following services
TYPE OF FUEL
CIRCLE ACTUAL UNIT DESCRIPTION FOR HEATING, AC, AND WATER HEATER
( central, wall, or forced heating )
( central, window, wall unit or n/a )
( one/unit or shared )
AMENITIES AND ACCESSIBILITY: (Che