Homeowner Property Intake Form

Property Registration & Screening

Homeowner Information

Full Name

Phone *

Email *

Preferred Contact Method:

Phone

Text

Email

Mailing Address:

Emergency Contact (optional):

Name
Phone

Property Details

Property Address:

Number of Rooms Available:

Bathroom Type:

Shared

Private

Kitchen Access:

Full

Limited

No Kitchen Access

Laundry Access:

On-site

Off-site

Public Transportation Nearby:

Yes

No

If yes, list bus lines/stops:

Rent & Financial Details

Monthly Rent Amount:

Security Deposit Required

Yes

No

If yes, specify amount:

House Rules & Expectations

Smoking:

Allowed

Outside Only

Not Allowed

Visitors:

Allowed

Limited

Not Allowed

Curfew or Quiet Hours:

Yes

No

If yes, specify:

Pets Allowed:

Yes

No

Alcohol Use

Allowed

Not Allowed

Additional House Rules:

Resident Preferences

Do you accept individuals with

Past Evictions:

Yes

No

Non‑violent Background

Yes

No

Mental Health Conditions:

Yes

No

Substance Use Recovery

Yes

No

Any restrictions or preferences:

If not, expected availability date:

Yes

No

Is the room/unit available now:

Yes

No

Upload or provide photos of the room/unit

Minimum Stay Requirement:

Maximum Occupancy:

Homeowner Agreement Acknowledgment

By submitting this form, I confirm that:

The information provided is accurate

The property is safe, clean, and habitable

I understand the Housing Liaison does not collect rent or manage tenants

I agree to communicate promptly about availability or issues

Homeowner Signature:

Clear

Date

I consent to receive marketing text messages, about special offers, discounts, and service updates, from LAWRI at the phone number provided. Message frequency may vary. Message & data rates may apply. Text HELP for assistance, reply STOP to opt out.

By checking this box, I consent to receive marketing and promotional messages including special offers, discounts, new product updates among others, from LAWRI at the phone number provided. Frequency may vary. Message & data rates may apply. Text HELP for assistance, reply STOP to opt out.

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