Landlord Information & Tax ID
Please note that this is a HIPPA compliant and secure form. Due to the volume of requests we receive we require your Tax ID to be on file for everyone receiving payment with the following exception. If you are a property management company and issue 1099's to your clients, we do not require your Tax ID.
Landlord/Property Manager Name
Street Address Line 2
State / Province
Postal / Zip Code
Please Enter Your Tax ID#
Your Phone Number
If this Tennant is approved for assistance, would you like payment via check or AHC electronic funds transfer.
AHC (a representative will contact you to set this up)
Signature of Landlord or Property Manager
Please verify that you are human
Should be Empty: