Tenants Request For Inspection
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Tenants Request For Inspection Form. This is a New York form and can be use in New York Local County.
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Tags: Tenants Request For Inspection, CIV-LT-61, New York Local County, New York
Civil Court Index No: LT/HP
Department of
Housing Preservation and Development
Division of Code Enforcement
County of
(Form A-B)
Housing Part:
TENANT'S REQUEST FOR INSPECTION
Room
The case of
vs.
will appear on the Court Calendar on:
Tenant's Name:
at
AM/PM
Tenant's Address:
Is there a child under the age of 6 residing in this apartment? Yes
Apt. No.
If yes, please provide name and age or date of birth for each child.
Floor:
Tenant's Phone #''s: Home: (
Work:
(
No
)
Name
Age/Date of Birth
)
You may gain access by contacting:
TENANT'S ALLEGATION OF VIOLATIONS
DIVISION OF
CODE ENFORCEMENT
Inspector's No:
Date:
Apt. No. (Or
Public Area)
Signature
Condition(s) - Be Specific
Which
Room?
REPORT
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
In connection with the above mentioned case in the Civil Court of the City of New York, I, the tenant of the apartment referred to, wish to call the Court's
attention to the conditions listed above which I allege are violations, and request that an inspection of the property be made to verify my allegations.
Tenant's Signature:
Date of Request:
INSPECTION TIME
INSPECTION DATE
10 AM - 2 PM
An inspector will come to inspect these conditions on:
2 PM - 6 PM
5 PM- 9 PM
Weekend 10 AM - 3 PM
Staten Island 10 AM - 2 PM
CIV-LT-61(9/06) (Replaces A&B)
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