This information helps the counselor understand the issues in your case. Intake Form Name* First Last Email* Affected Address* Street Address Address Line 2 City ZIP Code Phone*Current Rent for the Entire Unit: $* Amount You Pay: $* Number of Units in Your Building:* Your Unit:*1BR2BR3BRotherDo you live with Roommates?:*YesNoHow Many Roommates? Lease Start Date?* MM slash DD slash YYYY Lease End Date?* MM slash DD slash YYYY Condition of Building:*PoorFairGoodGreatLandlord/Mgmt Company:* Manager:* What is the main Problem you are here for?:*RepairsRent IncreaseSecurity DepositRoommates/ NeighborsLease QuestionsSub-lease QuestionsLandlord HarassmentEvictionOtherReason for EvictionOther Reason Description How did you hear about IVTU?*FriendDaily NexusOn CampusRadioFlyerOtherPlease let us know how you heard about IVTU Briefly State the Nature of your ProblemMessageCaptcha Δ