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Application For A Rent Reduction Based Upon …

State of New York Docket Number: Division of Housing and community Renewal Office of Rent Administration Web Site: Application For A Rent Reduction Based upon decreased building -Wide Service(s). 1. Mailing Address of Tenant: 2. Mailing Address of Owner: Name: Name: Number/Street: Apt. No.: Number/Street: City, City, State, Zip Code: State, Zip Code: Telephone No.: Bus. ( ) Telephone No.: ( ). Res. ( ). 3. Subject building (if different from tenant's mailing address): Number and Street Apartment Number City, State, Zip Code Instructions To Tenant: Before filing this Application , you should first notify the owner or agent in writing of all the service decreases in this Application .

RA-84 (3/14) Docket Number: Application For A Rent Reduction Based Upon Decreased Building-Wide Service(s) (SEE REVERSE SIDE) State of New York Division of Housing and Community Renewal

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