Management HandbookForm Instructions

RS-4HOUSING QUESTIONNAIRE

This form can be completed by a Traditional or *Non-Traditional Landlord; the Owner/Owner’s Agent via telephone interview; or as a **personal interview for applicant who do not have an available residential history.

An RS-4 form will be completed for every adult household member age 18 years or older listed on the application, includingemancipated minors. Only one (1) form is needed per address for persons who have established a household together. There will need to be one completed form for “each” address where the person/persons have lived in the prior two years.

The RS-4 “Questionnaire” is part of the screening process described in the “Resident Selection Plan”, Screening Process section.

Non-Traditional Landlord*: a friend or relative; living in a halfway house, a mental institution, in a homeless shelter, school dormitory, etc.

Personal Interview**: in domestic violence situations where the applicant is in fear; when the applicant has owned his/her own home, etc. Please contact your Occupancy Compliance Supervisor for additional assistance, if needed.

Form RS-4 may be mailed or faxed to the Landlord or Housing Provider. It is preferable for the Landlord or Housing Provider to complete the questionnaire. However, the Owner/Owner’s Agent may also telephone verify the information. Telephone verifications are acceptable especially if the move-in must occur in a short time period.

The Owner/Owner’s Agent will complete the “personal interview” with the Applicant(s) in person.

Please follow these instructions:

  1. Be sure to place the property’s address, telephone number and Fax number in the box provided on the form. Enter in the mailing address/fax number of the Landlord/Housing Provider (applicant name, etc. if conducting a personal interview); enter the date. Be sure to list the property’s telephone number, again, on the line provided. The Owner/Owner’s Agent will sign where indicated on the form.
  1. Ensure that the applicant’s name is entered. Then complete the address information for the address that is being “verified”.
  1. Under “Applicant Release” ask the applicant(s) to print his/her name, read the paragraph, and then sign and date as indicated. Please complete this part before the RS-4 is mailed, faxed or telephone verified; or before a personal interview is conducted.
  1. If the RS-4 is mailed, be sure to make a photocopy for reference. Be sure to include a stamped, self-addressed envelope for the return reply. When the completed form is returned, please check it for completion. If something is unanswered or the answer is confusing, please do a TC-12, Clarification Record with the person who completed the form. Then please discard the blank photocopy. If the form is returned via fax, please check it for completion as listed above. Then the blank original copy should be discarded. Be sure to only keep completed verifications.
  1. Place the completed form from the mail or fax in the applicant file. If move-in occurs, please place this information “under” the “Landlord” or “Housing” tab in the resident file.

For Telephone Verifications:

  1. Complete as in paragraphs 1, 2 and 3 above.
  1. Then, contact the housing provider and be sure to ask all of the questions as listed on the form. If a question does not apply to the applicant’s experience with them, enter in “N/A”. Please do not leave any unanswered questions. Always enter in the “Dates of Tenancy”; Month and Year is sufficient. This is because we are verifying a 2-year residential history.
  1. Be sure to answer what the person’s relationship is to the applicant(s). This establishes the housing situation.
  1. When the interview is complete, the Owner/Owner’s Agent must complete and then sign/date the form in paragraph # 8 on page 4 under “Owner/Owner’s Agent Telephone Interview”. NOTE: The “Signature” for the Landlord or Housing Provider above this section will have “N/A” written in. Owner/Owner’s Agents may NOT sign the name of the Landlord or Housing Provider.

For Personal Applicant(s) Interview:

  1. Complete as for “Telephone Verification” in paragraphs 1, 3 and 4 above. Since the applicant is being interviewed in person, part of question # 2 above will not apply. If a question does not apply to the applicant’s circumstances, please enter N/A as relevant.

2.When the interview is complete, the Owner/Owner’s Agent will enter the “Name of Applicant(s) Contacted” in paragraph # 8 of the form. The applicant(s) will need to sign under this line to verify that a person interview took place. Then the rest of the paragraph will be completed as indicated

Evaluating the results of the “Questionnaire” form is a very subjective task. However, a detailed guideline is set forth in the Resident Selection Policy, “Screening Policy Section”. For further guidance contact your Regional Property Supervisor.

If you have any other questions regarding this form and its requested information, you may also contact your Occupancy Compliance Supervisor in the Occupancy Department.

Landlord/Housing Questionnaire (9/08)1 of 2RS-4