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DALLAS COUNTYDEPARTMENT OF HEALTH AND HUMAN SERVICESHOUSING DIVISION
~EQUAL HOUSING
OPPORTUNITY
ZACHARY S. THOMPSON
DIRECTOR
DALLAS COUNTY HOUSING AGENCY LANDLORD REQUEST FORM
DDD
Hold (Do not advertise at this time)Add Property to Vacancy listDelete Property from Vacancy List
Property: D Condo D DuplexName of Complex:Address:City: Zip Code:Monthly Rent: $ Deposit: $Date property will be ready for occupancy:Owner Name: -Owners Address:Contact Name: -Contact Ph. No.: (E-mail Address:
Have you attended a Dallas County Housing Choice Voucher Landlord Briefing Meeting?DYES D NO
If YES, the date attended:
D House D Apartment D Town Home D Mobile HomeYear Constructed:
No. of Bedrooms/Bathrooms: /
Leasing Name:City: St/Zip:
1 Fax Number: ( 1
taxes, fines, or fees to Dallas County? DYES DNO
Are utility services included? YES NO
Are the range and stove provided? YES NO
Is the refrigerator provided?
Is the unit wheelchair accessible?
YES NO
YES NO
YES NOAre pets allowed? YES NO Does property meet City Code Regulations?
Housing Agency, 2377 North Stemmons Freeway, Suite 700, Ib-16, Dallas, TX 75207-2710
. DCHA is one of many avenues available to advertise your property. Other available sources are TheDallasMorningNews, the Greensheet,etc.
Thehousinglist is onlyavailableto DCHA's Section 8 clients..
. Please inform our agency when your property has been leased. If you would like delete your propertyfrom our available housing list, check the delete box and note the property address.
Additionalpropertiesmay be listedon the attachedpage... For additional inquiries please contact Deanna Gilmore, Landlord Coordinator at 214-819-6090.
2377 North Stemmons Freeway, Suite 700, LB-16Dallas, Texas 75207-2710
Office (214) 819-1871FAX (214) 819-2828
REV (C) 4/2010
1. Name of Complex:Address:City: .Monthly Rent: $
ADDITIONAL UNITSCondo Duplex HouseApt. Town Home Mobile Home
No. of Bedrooms/Bathrooms: /Year Constructed:
Are utility services included?
Are the range and stove provided?
Are pets allowed?
Zip Code:Deposit: $
YES NO
YES NO
Is the refrigerator provided?
Is the unit wheelchair accessible?
YES NO
YES NO
YES NO
2. Name of Complex:Address:City: -Monthly Rent: $
YES NO Does property meet City Code Regulations?
Condo Duplex HouseApt. Town Home Mobile Home
No. of Bedrooms/Bathrooms: /Year Constructed:
Zip Code:Deposit: $
Are utility services included?
Are the range and stove provided?
Are pets allowed?
YES NO Is the refrigerator provided?
YES NO Is the unit wheelchair accessible?
YES NO Does property meet City Code Regulations?
YES NO
YES NO
YES NO
3. Name of Complex:Address:City: -Monthly Rent: $
Condo Duplex HouseApt. Town Home Mobile Home
No. of Bedrooms/Bathrooms: /Year Constructed:
Zip Code:Deposit: $
Are utility services included?
Are the range and stove provided?
Are pets allowed?
YES NO Is the refrigerator provided?
YES NO Is the unit wheelchair accessible?
YES NO Does property meet City Code Regulations?
YES NO
YES NO
YES NO
4. Name of Complex:Address:City: -Monthly Rent: $
Condo Duplex HouseApt. Town Home Mobile Home
No. of Bedrooms/Bathrooms: /Year Constructed:
Zip Code:Deposit: $
Are utility services included?
Are the range and stove provided?
Are pets allowed?
YES NO Is the refrigerator provided?
YES NO Is the unit wheelchair accessible?
YES NO Does property meet City Code Regulations?
YES NO
YES NO
YES NO
5. Name of Complex:Address:City: -Monthly Rent: $
Condo Duplex HouseApt. Town Home Mobile Home
No. of BedroomslBathrooms: /Year Constructed:
Zip Code:Deposit: $
Are utility services included?
Are the range and stove provided?
Are pets allowed?
YES NO Is the refrigerator provided?
YES NO Is the unit wheelchair accessible?
YES NO Does property meet City Code Regulations?
YES NO
YES NO
YES NO