Accommodation Request

We are committed to the letter and spirit of the Fair Housing Act, which, among other things, prohibits discrimination against persons with disabilities. In accordance with our statutory responsibilities and management policies, we will make reasonable accommodations in our rules, policies, practices or services when such an accommodation may be necessary to afford persons with disabilities an equal opportunity to use and enjoy their housing communities. If you are requesting such an accommodation, please submit the form below.

Date

YYYY

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Cooperative

Please describe accommodation (exception to our usual rule or policy) that you are requesting:

Do you consider yourself to be disabled?

The Fair Housing Act defines disability as a physical or mental impairment that substantially limits one or more major life activities. The impairment must be permanent (continued for longer than 6-9 months) to be covered by the Fair Housing Act.

Yes

Please describe how the requested accommodation is necessary for your use and enjoyment of your space:

Please describe how the accommodation requested is connected to your disability: