RENT & UTILITY ALLOWANCE REQUEST

Click here to review the Rent Schedule and Utility Allowance Request instructions.

Do not use this form for Section 811 rent increases.

Development Name*

Project ID (PID)*

Rent*

The property is requesting a rent increase.The property is requesting a rent decrease.The property is only updating utility allowances; no change in rents is requested.

Rent Effective Date

Date

Rent Change

	Number of Units	Bedroom Size	AMI %	Program Designation	Current Rent Amount	New Rent Amount
#1
#2
#3
#4
#5
#6
#7
#8
#9

Utility Allowances*

Utilities are owner paid.Utilities are tenant paid.

Utility Allowance Effective Date

Date

Utility Allowance Changes

	Current UA Amount	New UA Amount
0 bedrooms
1 bedroom
2 bedrooms
3 bedrooms
4 bedrooms
5 bedrooms

Utility Allowance Backup

Date submitted*

Date

Contact name*

Title

Email address*

example@example.com

Phone #*

Feel free to download the final PDF for your records. Please do not additionally email the PDF to IHDA.

IHDA Rent and UA Request (Revised 10/29/2025)