Los Angeles County Rent Relief Program Interest Form

Provide us with your contact information to be notified in case additional resources for rental debt assistance become available.

First Name
Last Name
Email Address
Phone Number Phone Number - ### - ### ####
Address Address
Street Address Address Line 2 City State / Province / Region Country
Zip Code
Are you a tenant or a landlord?

Are you a tenant or a landlord? Tenant Landlord