Residential Multi-Unit Rental Questionnaire - LPC

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Multi-Unit Questionnaire

La Porte County / Michigan Township Assessor Residential Multi-Unit Rental Questionnaire

"*" indicates required fields

Owner*

Phone

Email*

Parcel ID*

Owner Mailing Address*

Street Address City State ZIP Code

Property Address*

Street Address Address Line 2 City State ZIP Code

Unit 1

Unit Type (Check all the apply)*

Main

Upper

Lower/Basement

Front

Rear

Side by side

Townhome

Monthly Rent*

Number of Bedrooms*

Number of Bathrooms*

Months Vacant (since last report)*

Parking (Check one)*

Garage

Off Street

On Street

Appliances Provided (Check all that apply)

Stove

Refrigerator

Washer/Dryer

Does the Tenant or Landlord Pay Water Bill?*

Water Bill (insert monthly average if paid by landlord)*

Does the Tenant or Landlord Pay Gas Bill?*

Gas Bill (insert monthly average if paid by landlord)*

Does the Tenant or Landlord Pay Electric Bill?*

Electric Bill (insert monthly average if paid by landlord)*

This unit is rented to a family member or friend.*

Yes

No

This unit is the owner's primary residence.*

Yes

No

This unit is a short term rental.*

Yes

No

If yes, where is it listed? (Check all that apply)

Airbnb

VRBO

Other

Add Another Unit?

Unit 2

Unit Type (Check all the apply)*

Main

Upper

Lower/Basement

Front

Rear

Side by side

Townhome

Monthly Rent*

Number of Bedrooms*

Number of Bathrooms*

Months Vacant (since last report)*

Parking (Check one)*

Garage

Off Street

On Street

Appliances Provided (Check all that apply)

Stove

Refrigerator

Washer/Dryer

Does the Tenant or Landlord Pay Water Bill?*

Water Bill (insert monthly average if paid by landlord)*

Does the Tenant or Landlord Pay Gas Bill?*

Gas Bill (insert monthly average if paid by landlord)*

Does the Tenant or Landlord Pay Electric Bill?*

Electric Bill (insert monthly average if paid by landlord)*

This unit is rented to a family member or friend.*

Yes

No

This unit is the owner's primary residence.*

Yes

No

This unit is a short term rental.*

Yes

No

If yes, where is it listed? (Check all that apply)*

Airbnb

VRBO

Other

Add Another Unit?

Unit 3

Unit Type (Check all the apply)

Main

Upper

Lower/Basement

Front

Rear

Side by side

Townhome

Monthly Rent

Number of Bedrooms

Number of Bathrooms

Months Vacant (since last report)

Parking (Check one)

Garage

Off Street

On Street

Appliances Provided (Check all that apply)

Stove

Refrigerator

Washer/Dryer

Does the Tenant or Landlord Pay Water Bill?

Water Bill (insert monthly average if paid by landlord)

Does the Tenant or Landlord Pay Gas Bill?

Gas Bill (insert monthly average if paid by landlord)

Does the Tenant or Landlord Pay Electric Bill?

Electric Bill (insert monthly average if paid by landlord)

This unit is rented to a family member or friend.

Yes

No

This unit is the owner's primary residence.

Yes

No

This unit is a short term rental.

Yes

No

If yes, where is it listed? (Check all that apply)

Airbnb

VRBO

Other

Add Another Unit?

Unit 4

Unit Type (Check all the apply)

Main

Upper

Lower/Basement

Front

Rear

Side by side

Townhome

Monthly Rent

Number of Bedrooms

Number of Bathrooms

Months Vacant (since last report)

Parking (Check one)

Garage

Off Street

On Street

Appliances Provided (Check all that apply)

Stove

Refrigerator

Washer/Dryer

Does the Tenant or Landlord Pay Water Bill?*

Water Bill (insert monthly average if paid by landlord)*

Gas Bill (insert monthly average if paid by landlord)*

Does the Tenant or Landlord Pay Gas Bill?*

Gas Bill (insert monthly average if paid by landlord)*

Does the Tenant or Landlord Pay Electric Bill?*

Electric Bill (insert monthly average if paid by landlord)*

This unit is rented to a family member or friend.

Yes

No

This unit is the owner's primary residence.

Yes

No

This unit is a short term rental.

Yes

No

If yes, where is it listed? (Check all that apply)

Airbnb

VRBO

Other

A copy of the current lease is requested if one is not already on file with our office. Per IC 6-1.1-35-9, any information pertaining to income and expense is constitutionally protected and will remain confidential.

Drop files here or

Max. file size: 48 MB.

La Porte County

County Complex
809 State St.
La Porte, IN 46350

219-326-6808

Monday - Friday:
8:00 AM - 4:00 PM

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