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Notice of COVID-19 Impact
You should only use this form if you live in Chicago and your ability to pay rent has been impacted by COVID-19.
Step 1 of 4
25%
Which one of these is true?
*
I have received a 5 day notice
I have not received a 5 day notice
If you have received a 5 day notice, then you can only use this form if the notice has NOT expired.
Which one of these is true?
*
I live in subsidized housing
I live in public housing
Neither of the above apply
Would you like to see a sample of the Notice you'll create?
Yes
No
Title of the document
Sample Letter
Tenant Information
Name
*
First
Last
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Phone
*
Email
*
I'm sorry. You entered a city outside of Chicago and cannot use this form.
Landlord Information
Management Company
If there is one
Landlord Name or Property Manager/Contact
*
If there is a management company and the tenant does not have a contact, please enter Property Manager
Would you like Rentervention to email the letter to your landlord?
*
Yes
No
Landlord Email
*
Enter Email
Confirm Email
Landlord Phone
Landlord Address
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Consent
*
I agree to the terms below
I understand that I am solely responsible for the use of this template. In choosing to send the letter to my landlord by email, I'm using this form responsibly and the email address I supply for my landlord is my landlord's email address.