* (denotes required field)

First Name: *

Last Name: *

E-Mail Address: *

Affected Address *

City *

Zip *

Phone *

Current Rent for the Entire Unit: $ *

Amount You Pay: $ *

Security Deposit Paid: $ *

Number of Units in Your Building: *

Your Unit: *

1BR 2BR 3BR other

Do you live with Roommates?: *

yes no

How Many Roommates? *

Lease Start Date? *

Lease End Date? *

Condition of Building: *

Poor Fair Good Great

Landlord/Mgmt Company: *

Manager: *

Check Applicable: *

UCSB Undergrad Student UCSB Graduate Student SBCC Student Community Member Property Owner/ Manager

What is the main Problem you are here for?: *

Repairs
Rent Increase
Security Deposit
Roommates/ Neighbors
Lease Questions
Sub-lease Questions
Landlord Harassment
Eviction
Other

If evicted, what was the reason?

If there is another problem you are here for, what is the reason?

How did you hear about IVTU?; *

Friend
Daily Nexus
On Campus
Radio
Flyer
Other

If other, please explain:

BRIEFLY STATE THE NATURE OF YOUR PROBLEM

Message:

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