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Housing Choices Voucher Program Registration

Landlord Name:

Phone:

Race and Ethnicity:

Sex:

Male
Female

E-Mail Address:

Property Address:

City:

State:

Ohio

Zip Code:

Type:

Year Built:

# of Bedrooms:

# Bathrooms:

Rent Requested:

Security Deposit Required:

Included Utilities:

Natural Gas

Electricity

Water/Sewer

Included Appliances:

Refrigerator

Range

Included Amenities:

Pets Allowed

Basement

Laundry Facilities

Storage

Parking

Comments:

Signature

Date:

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Attention Is Needed

There were some problems with the information you have submitted. Listed below are the fields that need attention.

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