Florida Covid-19 Mortgage/Rent survey
Florida residents only. The processes and actions that prove successful as a result of this survey will be packaged into a model for other states and communities to use.
Sign in to Google to save your progress. Learn more
Are you *currently* out of work (or working less) because of Covid-19? *
If you are not working (or working less) because of Covid-19, are you being compensated for the lost time in any way (including paid sick or other paid leave)? *
Do you have a rent or mortgage payment? *
What Florida County do you live in? *
What is your Zip Code? *
Name of apartment community (If renting in an apartment community. Use "private home" if you rent a condo or house, and leave blank if you pay a mortgage).
Email for *anyone* at your apartment community's office (if applicable). This is optional, but helpful if you can provide it. You can provide a landlord's email as well.
If you pay a mortgage, who is your mortgage servicer? (Leave blank if you rent)
If you pay a mortgage, is it enterprise-backed? (Fannie Mae/Freddie Mac) *
Your contact Email. This is optional and will only be used to follow up and provide you with information/instructions. The other information in this survey is still helpful if you aren't comfortable submitting an email.
Are you willing to help in this process? We may need points of contact in each county, and in larger counties, specific communities. If so, please make sure you submit your email above.
Clear selection
If you are willing to provide your name to petition Florida Courts to freeze rent/evictions/mortgage/utility shut offs, please enter your first and last name.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy