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If you are experiencing an eviction related dispute, please fill out the form below.
Are you having problems with your rental relationship or rental situation?
Tenant
Landlord / Management Company
placeholder "Street Address*"]
placeholder "City*"
Ownership/management interest in the property
---
Landlord/property owner who self manages the property
Individual property manager
Corporate property manager
Realtor
In-house leasing specialist
Other (such as a relative of the property owner)
Please describe the current housing issue with your tenant.
Have you been financially impacted by COVID-19?
Yes
No
If yes, Briefly describe how you or someone in your household has been impacted.
Do you have a child or children under the age of 18 or 18 and still in high school living in your home?
Yes
No
If yes, how many and what are their ages?
Are you behind in rent?*
yes
no
If yes, how far behind are you (i.e., how many months):
If you are behind in rent, have you applied for assistance through Pinellas County’s online Emergency Rental Assistance Program?
yes
no
Have you received any type of notice to vacate from your landlord or an eviction summons?
yes
no
If yes, please tell us what the notice says:
Please let us know anything else you think is important.
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