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HABITABILITY INTAKE FORM

Did the Landlord Attempt Any Repairs?
Did the Landlord Attempt Any Repairs?
Did the Landlord Attempt Any Repairs?
Did the Landlord Attempt Any Repairs?
Did the Landlord Attempt Any Repairs?
Do You Have Any Physical Injuries From Your Tenancy? (Ex. Bed Bug Bites, Sinus Issues Related to Mold?)
Do You Have Emotional Injuries/Distress From Your Tenancy?
Did You See a Doctor for Emotional or Physical Injuries?
Do You Have Receipts or Pictures of the Lost Property?
Did You Miss Work Due to the Problems at Your Unit?
Did the City Code Enforcement, County Vector Control, and/or Housing Authority Inspect or Make a Report?
Do You Owe Back Rent?
Do You Believe That The Landlord id Realiating or Discriminating Against You?
If You Made Repairs, Do You Have Receipts or Any Proof of Repairs?
Do You Have Copies of Any Notices Given to You by The Landlord?
Do You Have Letters, Emails, or Texts with Your Landlord?
Do You Have Pay Stubs Showing the Missed Time?
Were You Evicted?
Did Your Landlord Serve You With a Notice to Vacate?
Did You Make Any Repairs?
Do You Have a Copy of Your Lease?
Do You Have Copies of Any Notices Given to You by the City/County/Housing Authority?
Do You Have Photos of the Correspondence?

Thank you for filling out this form. We will get back to you as soon as possible.

LET US HELP YOU!

ADDRESS

39675 Cedar Blvd. Suite 250, Newark, CA 94560​

Get Directions

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PHONE

(510) 573-1043

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FAX

(510) 573-3156 

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EMAIL

jennifer@jrslawoffices.com

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OFFICE HOURS

Monday - Saturday 9:00 am - 6:00 pm

Thank you for contacting us. We will get back to you as soon as possible.

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