LANDLORD VERIFICATION FORM Behavioral Health Recovery Program (BURP) Basic Fax: 1-866-249-8766 APPLICANT S NAME: DATE: Monthly Rent: $ Security Deposit: $ Has Security Deposit Been Paid? Applicant.

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How to fill out the CT Advanced Behavioral Health Landlord Verification Form online

This guide will help you navigate the CT Advanced Behavioral Health Landlord Verification Form, ensuring you complete it accurately and efficiently online. Follow the steps outlined below to successfully fill out the required fields and submit your information.

Follow the steps to complete the landlord verification form online.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Fill in the applicant’s name and the date on the form. This is crucial for identifying the individual associated with the verification request.
  3. Input the monthly rent amount and the security deposit amount, if applicable. Ensure these figures are accurate to avoid issues during processing.
  4. Indicate whether the security deposit has been paid, along with the applicant’s move-in date. If the deposit has been paid, provide the date of payment and the amount paid.
  5. Enter the exact address where the participant will be residing, as this information is essential for verifying the rental situation.
  6. Provide the name of the owner, along with their FEIN or SSN for identification purposes.
  7. Fill in the owner's address and telephone number to ensure proper contact details are included.
  8. Select the rental unit type from the options provided, entering the number of bedrooms in the rental unit.
  9. Specify the maximum allowable occupancy according to local zoning regulations and the number of people living in the household per the lease agreement.
  10. Indicate whether all household members are related or not, and if not, provide the number of unrelated people living in the household.
  11. List all residents permitted to live in the unit, including ages for those under 18 years old. This section is important for compliance and verification.
  12. Check any utilities included in the rent, such as heat, electricity, gas, oil, hot water, meals, and any other applicable services.
  13. Complete the owner's and lessee's attestations sections by reading and affirming the statements provided, understanding the responsibilities involved.
  14. Sign and date the form as the owner and as the participant, ensuring that all information is current.
  15. Submit all required documentation, including the lease, W-9, and proof of income, and ensure that all forms are faxed to ABH®.
  16. If any changes are made after the initial submission, ensure that the owner initials those changes for verification.

Complete your landlord verification requirement smoothly by filling out the CT Advanced Behavioral Health Landlord Verification Form online today.

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