Michigan Tenants Counseling Program

Are you a University of Michigan student? If yes, contact Student Legal Services.

Your information will be kept confidential by us, and will only be disclosed by our counselors
in order to resolve your problem. We will not disclose your information to any third party
without your permission.

Part 1 - Your Information
First name:
Last name:
Street Address:
City:, MI
Zip Code:

Your phone number [(xxx) xxx-xxxx]:
Another number where you can be reached:
Your email address:

Age:

Do you have a physical disability or health impairment? yes   no


Race/ethnicity (to make multiple selections, complete boxes 1-2 as necessary)
1)    2) 

Does your household include other races or ethnicities? If yes, please complete boxes 3 and 4 as necessary.

3)    4) 

Are you Hispanic? yes   no


What is your annual income?
Number of people in your household:
Who is the head of your household?



Part 2 - Information about the Rental Property
Same address as above? yes   no
If no, please fill out the address below.
Street Address:
City:, MI
Zip Code:
Landlord:
Property Owner (if different from landlord):



Part 3 - Your Question
Please describe your situation and type your questions in the box below.


Do you have a lease? yes   no
If yes, when did your lease begin?
When does it end?
How much is the monthly rent for your entire apartment or house?
Are you behind in your rent? yes   no


We collect tenants' questions and our answers for the
"frequently asked questions" section of our website.
May we have your permission to post portions of your
question and our response, without identifying you?
yes

Check here if you would like to receive a copy of this message.

yes


Final Step
Please review the information you provided, and click the "send message" button
when you are finished



This form is powered by Jack's Formmail.php!