Case Number: Case Number Worker ID: Worker IDLandlord QuestionnaireThis authorizes you to release information to the Iowa Department of Human Services. Please return the completed form using the enclosed.

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How to fill out the IA 470-1632 online

Filling out the IA 470-1632 form is an essential task to provide information to the Iowa Department of Human Services. This guide will take you through each step to ensure that you complete the form accurately and efficiently.

Follow the steps to successfully complete the IA 470-1632 form.

  1. Press the ‘Get Form’ button to access the IA 470-1632 document and open it in your preferred editing tool.
  2. Begin by filling out the case number and worker ID at the top of the form. Ensure that this information is accurate for proper identification.
  3. In the 'Landlord Questionnaire' section, provide the necessary tenant's signature and date beneath the relevant fields.
  4. Complete the 'Household Members' section by writing the names of all individuals living in the household for the corresponding month.
  5. Move to the 'Rent' section and fill in the rent billed to the tenant and the amount billed to housing assistance for each month provided.
  6. In the 'Other Charges' section, list any additional charges that apply, such as garage fees, pets, or late fees. Answer whether any of these charges are included in the rent/lot rent.
  7. Indicate which utilities the tenant is responsible for paying and list any extra charges for utilities included in the rent. Provide details such as seasonal air conditioning or other utility costs.
  8. At the bottom of the form, ensure you sign and print the landlord's name, along with their address and contact number.
  9. Once all sections are completed, save your changes, then proceed to download, print, or share the form as needed.

Complete your IA 470-1632 form online to ensure a smooth submission process.

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dhs.iowa.gov/sites/default/files/470-1632.pdf

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