Annual Rent Adjustment Form

Both the tenant and the CHA must receive a 60-day written notice of any proposed change in the lease. Rent increases are effective on the anniversary date of the HAP Contract. Rents are approved based on the market rents for units of comparable size, condition, location, amenities and services.

Note: If the gross rent is greater than the payment standard for the family’s approved unit size, a rent increase will increase the amount owed by the tenant. When this occurs, the family was already receiving the maximum allowable subsidy based on their income and family size.

Please complete the required (*) fields.

Please describe the reason(s) for rent adjustment.

Please describe extraordinary repairs in the last year or since the last rent increase.

Please describe improvements in the last year or since the last rent increase.

Utilities/Appliances Included

Please check the appropriate boxes. *


Comparable Unit Information

Comparable unassisted units at or above the proposed rent.


The CHA may request additional documentation from the owner to support proposed rent increase.


I hereby certify that the foregoing information is correct and no changes to the lease will be made without a 60-day written notice to the Tenant and Chester Housing Authority. I understand that inquiries may be made to certify facts and statements contained herein.

Please answer the arithmetic question *

What is 3 + 2? | |