Damage & Vacancy Loss Claim Form

Please file a claim for eligible damage or vacancy losses for a unit leased through the LIFT initiative.

 

Part 1: Owner & Tenant Information

 
 
 
 
 
 
 
 
 
 
 
 

Part 2: Security Deposit

 
 
 

Part 3: Damage Claim

 
 
 

This may include cleaning costs, extermination costs, and legal fees under certain circumstances.

 

Part 4: Vacancy Loss

 

Vacancy Loss is only eligible for the below scenarios. Vacancy loss is not rental assistance and cannot pay late rent when a tenant is still occupying the unit.

 
 
 

(If the tenant vacated in April, you would count the days vacant in May).

 

Vacancy loss is capped at one month of rent. Owners are required to upload proof of re-listing the unit to LIFT or other sources to be eligible for this benefit.

 

Part 5: Verification of Claims

 
 
 

If requesting damage reimbursement for labor, at least two quotes must be provided to show a competitive rate was paid.

Drop your files here
 

Part 6: Signature

 

Type name below for e-signature