DEPARTMENT OF HOUSING PRESERVATION AND DEVELOPMENT (HPD)
BEDBUG ANNUAL REPORT
INSTRUCTIONS
REQUIREMENT: Owners of residential buildings with 3 or more residential units are required to annually
request information from building occupants about bedbug infestations, and, based on that information and
the owner’s activities during the year, file a Bedbug Annual Report with HPD. The filing requires information
about bedbug infestations and the number of eradications of bedbugs. Property owners must file a Bedbug
Annual Report even if the building is bedbug free.
HOW CAN OWNERS FILE: This hard copy form can only be filed by owners who indicate an ownership type of
INDIVIDUAL OWNER or JOINT OWNER on their Annual Property Registration. All other owners must submit
this information online. You can access the portal for submission by going to HPD's website, searching
Bedbugs, and reviewing the tab labelled Bed Bug Annual Report Requirement on the Bedbug information page.
Note that for both the hard copy form or the electronic reporting, the property must be registered with HPD
for HPD to accept this report. Property owners can find out more about property registration and initiate the
registration process by clicking on the Register Your Property feature on the homepage of HPD's website
(www.nyc.gov/hpd) or by calling 212-863-7000 for Property Registration assistance.
WHAT PERIOD IS THE FILING FOR: The reporting period to be covered in the Bedbug Annual Report is November of the
previous year through October of the current year. Property owners will be required to file a Bedbug Annual Report
between December 1 and December 31. Once December 31 passes, HPD may issue a violation for failure to file.
PROCESS AFTER FILING: ALL REQUESTED INFORMATION MUST BE PROVIDED OR THIS FORM WILL BE REJECTED.
After
processing a properly completed report, HPD will send the owner a receipt. The owner is required to provide the filing to
the tenant, either by posting the report or distributing it to tenants. The property owner is also required to either
distribute or post a copy of DOHMH’S Bedbug Information Notice in a prominent public location in the building. This
notice provides information about the prevention, detection and removal of bedbug infestation. You can obtain the
DOHMH notice here: https://www.nyc.gov/assets/doh/downloads/pdf/vector/vector-faq1.pdf .
QUESTIONS ABOUT THIS FORM: If you have questions about how to complete this form, you can contact
Mail Completed Form to: NYC Department of Housing Preservation & Development
Division of Code Enforcement
100 Gold Street, 5-Z14C
New York, NY 10038
BEDBUG ANNUAL FILING
DEPARTMENT OF HOUSING PRESERVATION AND DEVELOPMENT
Premises Address:
Borough Reg ID
Filed By Name:
(Print)
Address:
Phone #
:
24-hour confidential number (as provided in Section 10 of your Annual Property
Registr
ation)
Report Period: November 2022 through October 2023
SECTION I: I am the: (Check One)
Individual or Join Owner of the property as listed on the Property Registration form filed with HPD
Managing Agent of the property as indicated on the Property Registration form filed with HPD
SECTION II: Complete 1-4. You mus
t
enter a number in each box for the
f
orm to be valid.
1) Total Dwelling Unit Count:
The total number of units in the multiple dwellin
g
(whether or not the unit is occupied).
2) Infested Dwelling Unit Count:
The number of units, as reported by a tenant or otherwise known to the property owner, to have had a
bedbug infestation during the Report Pe
riod.
3) Eradicated Dwelling Unit Count:
The number of units where eradication measures were employed during the report period.
4) Re-infested Dwelling Unit Count:
The number of units that reported having a bedbug infestation after eradication methods were employed
during the report period.
SECTION III: I certify that: (Check On
e)
A copy of this form and the DOHMH Bedbug Information Notice will be posted in a prominent location
within the building within the 60 days of filing, and I will maintain a record of such posting.
A copy of this form and the DOHMH Bedbug Information Notice will be given to each tenant within such
multiple dwelling upon each lease renewal or the commencement o
f
a new lease.
Signature o
f
Filer Date
Revised 10/2023
