Tenant Mold/Mildew Complaint Form
Tenant Name
Unit/Apartment Number
Contact Number
Email Address
Date Mold/Mildew First Noticed
Location of Mold/Mildew in Unit
Description of Issue
Extent of Mold/Mildew (Size/Spread)
Suspected Cause, if Known
Any Health Symptoms Experienced?
Has This Been Reported Previously?
Yes
No
Additional Information