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Relocation Assistance Exemption Report

  1. Relocation Assistance Exemption Report Form

  2. Pursuant to EC 8.425 (17)(g)5 a landlord must report exemptions under certain circumstances to the City in order to qualify for an exemption from the relocation assistance requirements. Regulated Affordable Housing units are not required to report their exemption.

  3. Rental Dwelling Unit Information

  4. Exemption Information

  5. Property Owner Information

  6. Property Management Information (if applicable)

  7. Electronic Signature

  8. By signing this form, I acknowledge that the tenant(s) residing in the rental dwelling unit address listed above have been notified of the exemption as required by EC 8.425(17)(g).

    This form is designed to be completed and signed by the legal owner(s) of the rental dwelling unit where exemption from the obligation to pay city relocation assistance is claimed. If someone other than the property owner/landlord is completing this form on behalf of the owner/landlord, the undersigned certifies that they are legally authorized to act on behalf of the property owner/landlord to complete this form. 

  9. I am the:*
  10. Electronic Signature*
    By checking this box, I am providing an electronic signature.
  11. IMPORTANT: Once you click Submit, you will not be able to edit your submission. Click "Save Progress" if you are not finished and you want to come back and edit.

  12. Leave This Blank:

  13. This field is not part of the form submission.