Fillable Wisconsin Rental Assistance Program (WERA) Request for Assistance

Fill Online, Printable, Fillable, Blank Wisconsin Rental Assistance Program (WERA) Request for Assistance Form

Use Fill to complete blank online OTHERS pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Wisconsin Rental Assistance Program (WERA) Request for Assistance

On average this form takes 10 minutes to complete

The Wisconsin Rental Assistance Program (WERA) Request for Assistance form is 2 pages long and contains:

  • 2 signatures
  • 12 check-boxes
  • 25 other fields

Country of origin: OTHERS
File type: PDF

BROWSE OTHERS FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Re
v: 03/31/2021 Page 1 of 2
Wisconsin Rental Assistance Program (WERA)
Request for Assistance / Renter’s Verification
This document provides a way for the landlord/rental agent to verify the terms of tenancy of the applicant. This
document can be used in the place of providing a written lease I but does not replace a written lease between the
tenant and landlord. If this form is utilized, it must be completed and signed by the landlord/rental agent.
Applicant Name
Unit Address
City, State, Zip
Phone
Email
Total Assistance
Requested
$
Description of
Assistance Requested
Ten
ancy Information:
Property Owner
Manager/Rental Agent
Address
City, State, Zip
Phone Fax
Email
R
ental Agreement Information:
Rent Amount $
Rent Due
☐
weekly
☐
monthly
☐
other (Click or tap here to enter text.)
Total Past Due Rent $
Type of tenancy
☐
one year (term: Click or tap here to enter text.)
☐ months (term: Click or tap here to enter text.)
☐ month-to-month (start date: Click or tap here to enter text.)
☐ week-to-week (start date: Click or tap here to enter text.)
Payment method for
heat and electric
Heat
☐ Included in the rent
☐ Separate Payment is made to the
Landlord
☐ Tenant pays directly to utility vendor
Electric
☐ Included in the rent
☐ Separate Payment is made to the
Landlord
☐ Tenant pays directly to utility vendor
B
y typing my name in the ‘Agency/Landlord Agency Signature’ field, I indicate that I am the person named, and this entry is the legal
equivalent of a manual/handwritten signature. I further understand that I may print out the document and sign by hand.
Signature of owner, landlord or rental agent
Signature of applicant
click to sign
signature
click to edit
click to sign
signature
click to edit
Rev: 03/31/2021 Page 2 of 2
Emergency Rental Assistance: Completed by WERA Staff Only:
Rent Assistance Arrears
$
Rental Assistance Needed
$
Lot Assistance Arrears
$
Lot Assistance Needed
$
Security Deposit
$
Description of Assistance
Requested
Please list the total amount of arrearages and late fees due for each month below.
Please list rent amount and any fees separately.
For example: August 2020 - $550 Late Fees: $50
Total Past Due Rent
(including fees)
$
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Wisconsin Rental Assistance Program (WERA) Request for Assistance

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 6 July 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document