Completing this form will place your unit on the OCHA referral list. Note this unit is subject to a rent reasonable test and must pass a Housing Quality Standard inspection. You must have JavaScript enabled to use this form. How did you hear about us? Hapcheck.com Website Other/Media Please choose one: New Owner Existing Owner Property Name: Property Address: Property City/Zip: Manager/Owner Name: Phone Number 1: Phone Number 2: Email Address: Unit Type: Single Family Residence Condo Townhouse Apartment Duplex Triplex Upstairs Ground Floor 1-Story Handicap Accessible Seniors Only 2-Story Bedroom(s) - None -01234 Bathroom(s) - None -1234 Date Available: Rent $ Owner Paid Utilities: Gas Electric Water Trash Water Heater Amenities, Services and Maintenance: A/C-Central A/C-Wall Unit Refrigerator Dishwasher Ceiling Fans Fireplace Garage Carport Balcony Fenced Yard Pool/Spa Playground Pets OK Patio/Deck Washer/Dryer Hookups Washer/Dryer in Unit Laundry Facility Garbage Disposal Elevator If you checked Garage above, please indicate size: - None -1 Car2 Car3 Car Comments: OCHA Referral Email Address: ocha.referral@occr.ocgov.com
