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Complete Your Custom ORHA Rental Form

Please Fill In the Form

Save/Update Auto-Fill Entries

O5 : NOTICE OF EMERGENCY ENTRY

Required entries are indicated by blue icons or *

Tenant(s)* (required)

Tenant(s)

et al (and all others)

Property Address* (required)

Unit #

City (Oregon ONLY)

OREGON Zip Code

Due to an emergency, your Rental Unit was entered on:

Date of Entry

Time of Entry

a.m.

p.m.

The person that entered was:

Name of Person Entering

Nature of Emergency

Action Taken

This notice has been left at the Rental Unit in accordance with ORS 90. If you have any questions or concerns, please notify Owner/Agent in writing immediately.

Please Note: Signature field must be filled in and signed after printing.


Owner/Agent Signature:			Date:

Owner/Agent

Address

City

State

Zip

Telephone

O5 : NOTICE OF EMERGENCY ENTRY

Rev.4/16

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