Managing Agent Inquiry Form

Human Resources Administration311

SNAP & CA Housing & Prevention Services Health Assistance Other Benefits & Services

This Inquiry Form is for managing agents to submit their inquiries/concerns/issues to Human Resources Administration’s Housing Services Team for review.

The range of issues that the team can review are listed below.

Upon completion of this form, you will receive a follow-up email along with a reference number detailing next steps.

* Indicates required fields

What subsidy are you reaching out about?*

Are you a registered user on CurRent?* Yes No

Have you completed the DSS Authorized Point of Contact Designation Form?* Yes No

Managing Agent or Company Information

Please confirm:* Our client has a tenant who receives a housing subsidy from the Human Resources Administration (HRA)

Managing Agent's Company Name*

Managing Agent First Name*

Managing Agent Last Name*

Managing Agent or Company Mailing Street Address*

Managing Agent or Company Mailing Apartment/Suite

Managing Agent or Company Mailing City*

Managing Agent or Company Mailing State*

Managing Agent or Company Mailing ZIP Code*

Your Email*
We will send you a confirmation email with the correspondence number that is associated with your request to this email address once this form is submitted. You will also receive a response to this email address that asks you to send supporting documents.

Your Phone Number*

Landlord First Name*

Landlord Last Name*

Tenant Information

Tenant First Name

Tenant Last Name

Tenant Street Address

Tenant Apartment/Suite

Tenant City

Tenant State

Tenant ZIP Code

Certification

I certify that I am the person submitting this form online and that the information provided is accurate and complete to the best of my knowledge. I further certify that I have read, understood, and voluntarily agreed to submit the information required to process my request.

Enter your name in lieu of signature*

Date Submitted*

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

If you’re having technical difficulty in submitting this form, please submit a clear description of the issue you’re facing here.