Alachua County ERAP Landlord / Property Manager Statement

(For rental payment assistance)

Instructions: Landlord / Property Manager, please complete the section below. In order for a rent assistance payment to be processed, the
Landlord/Property Manager MUST complete and SIGN the section below and upload to the application in Neighborly.

I verify that I am the Landlord/Property Manager for: Cynthia M Miller

Name(s) of Tenant(s)

who is/are currently residing at: 120 SW 13th PL #1014

Rental Property Street Address, including Apt. #
Gainesville, FL 32607
City, State, and Zip Code

and who is/are legally responsible for a rent payment of: $ 950 per month,
which is the basic monthly rent (and utilities or other service fees if included in rent) and does not include any other fees
(i.e., late fees, legal fees, penalties, or deposits).

Rent is due on the: 3rd (day of the month –i.e., 1st, 15th, last day ) and is considered late on the
5th of each month.

Month for which Amount of rent (excluding Month for which rent Amount of rent (excluding
rent is due fees/penalties) outstanding is due (continued) fees/penalties) outstanding

March 2020 February 2021 950

April 2020 March 2021 950
May 2020 April 2021 950
June 2020 May 2021 950
July 2020 June 2021 950
August 2020 July 2021 950
September 2020 August 2021 950
October 2020 September 2021 950
November 2020 October 2021 950
December 2020 November 2021 950
January 2021 950 December 2021 950

Total outstanding (rent ) amount due for periods after March 13, 2020: 11,400

Total late fees requested to be paid $ 600

Total amount outstanding $ 12000

Woodlands of Gainesville LLC Woodlands Apartment Complex

Printed Name of Landlord/Property Manager Name of Apartment Complex or Property Name (if applicable)

06/15/2023
Signature of Landlord/Property Manager Date