Change Request

Project Name

Project Street Address

Zip Code

Owner

Who is Your Asset Manager

Andrea Smith (andrea.smith@seattle.gov)

Jamie Wood (jamie.wood@seattle.gov)

Lacey Barker (lacey.barker@seattle.gov)

Summary of Requests

Person Submitting Request

Title/Role

Email Address

Anticipate Resolution/Closing Date

mm/dd/yyyy

Names of additional supporting staff/consultants

Emails of additional staff/consultants

Attorney Name (if applicable)

Attorney Email

Total Units

Total SOH Restricted Units

Current Units at 30%

Current Units at 31-50%

Current Units at 60%

Current Occupancy Rate

Replacement Reserve Balance

Operating Reserve Balance

How Long Are You Requesting To Forbear

Is renovation/rehabilitation part of the proposal?

What is The Total Cost of the Relocation Plan

Number of Over-Income Tenants

Number of Rent Burdened Tenants

Provide projects current challenges.

Forbearance Documents Needed

Supplementary Materials

If your request requires any supplemental materials, please submit up to 50 attachments here.

File upload

Drop your files here

Send me a copy of my responses