Franklin County

OFFICE OF THE ASSESSOR

JOHN A ROSENAU – ASSESSOR

Rental Income Verification Form

Parcel Number:

Address:

Complex Name:

Number of Units:

Typical Lease: (Check one)
1 Year
6 Month
3 Month
Month-to-Month
Other:
Rent Subsidized By: (Check one)
None
IRS Section 8
IRS Section 15
IRS Section 42

In lieu of completing the rental income and operating expense section of the form, you may attach a current rent roll and operating income expense statement.

Rental Units Table

# of Units: Enter total number of each size of unit
# of Baths / Unit: Enter total number of bathrooms in corresponding styles
Current Rent:($) Enter rent or high/low range of rent
Vacant Units: Enter annual vacancy percentage.

Style Studio 1 Bed 2 Bed 3 Bed 4 Bed Carport Garage
# of Units
# of Baths / Unit
1 bath
2 bath
3 bath
1 bath
2 bath
3 bath
1 bath
2 bath
3 bath
1 bath
2 bath
3 bath
1 bath
2 bath
3 bath
Current Rent ($)
Vacant Units
Owner/Manager Occupied unit(s):
Check this box if an owner/manager does not occupy an apartment and skip to "Amenities included in Rent".
Bed:
Bath:
Rent: $

Does owner/manager occupied rent included in Management & Payroll expense below?
Yes No

Amenities included in Rent (Check all that apply):
Swimming Pool
Tennis Courts
Clubhouse
Exercise Room
Sauna
On-Site Manager
Private Storage
Cable TV or Satellite
Playground Equipment
Washer/Dryer

ANNUAL INCOME (If owner occupied, skip to annual expenses)

Item 2023 2024
Actual Rental Revenue
Rent Concessions
Other (Laundry, Vending, Parking, Etc…)
TOTAL ANNUAL INCOME

ANNUAL OPERATING EXPENSES

Item 2023 2024
Insurance
Management & Payroll
Utilities
Supplies
Repairs/Maintenance
Other
Reserves for Replacements
TOTAL ANNUAL EXPENSES
Expense Paid By: (Check for each)
Utility Tenant Landlord
Water
Garbage
Sewer
Electricity
Gas

Name of Respondent:

Title:

Daytime Phone:

Date:

Email Address:

*See instruction page for aid filling out this form

*Do not include debt services, interest, depreciation or property taxes as expense

Robert Fisher – Commercial Appraiser
Phone: (509) 545-3506
Email: rfisher@franklincountywa.gov
All information received will be kept confidential under the provisions RCW 84.40.020

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