Attorney Referral Service

(Housing Rights Lawyer Referral Service - California State Bar #0120)

Referral for Renters | Referral for Homeowners

Attorney Referral For Renters

Zip Code:
(must be city we serve)

Where did you hear about HRI:

First Name:

Last Name:

Phone Number:

Email:

Name of person you are contacting us about, if different:

Their phone number:

Address that you are contacting us about

(must be city we serve)

Type of unit:

Name of Apartment complex:

Number of units:

How long have/did you live there?

Are you living there now?
Yes
No

Are there witnesses that have direct knowledge of the facts in your complaint?
Yes
No

How many?

Do you have pictures?
Yes
No

Is there an official inspection report?
Yes
No

Summary of Complaint

Who is involved in your complaint

(provide name, phone number and relationship to you (landlord, brother-in law, etc.)

What is your complaint?

Where did this occur?

When did this happen exactly:

How has this incident effected you and your household?

Attorney Referral For Homeowners

Zip Code:
(must be city we serve)

Where did you hear about HRI:

First Name:

Last Name:

Phone Number:

Email:

Name of person you are contacting us about, if different:

Their phone number:

Address that you are contacting us about

(must be city we serve)

Type of unit:

Are you inquiring about your loan?
Yes
No

If not skip down to last question

Have you signed the loan papers?
Yes
No

When did you sign?

Sources of your household’s income? (check all that apply)
Employment
Disability
Retirement
SSI
Unemployment

Total household unemployment income for the month:

Name of lender:

Type of loan:

Total amount of loan:

Terms of loan:

Interest rate:

How many loans are on your home now?

Did some one suggest you take out this loan?

Are you behind in your payments:
Yes
No

Received a notice of default?
Yes
No

If not about your loan, why are you contacting us?