Tenant Petition For Rent Withholding For Failure To Register Form Page 3
Download a blank fillable Tenant Petition For Rent Withholding For Failure To Register Form in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Tenant Petition For Rent Withholding For Failure To Register Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
45.
Grounds: I/we request authorization to withhold rent because: (Check all applicable grounds)
( )
1. Exempt Status: The landlord erroneously claims that one or more units is exempt from the
Rent Stabilization Ordinance. Specify the unit(s) and the reason you believe it is not exempt.
_________________________________________________________________________________
_________________________________________________________________________________
( )
2. Initial Registration Statement: There is no Initial Registration Statement on file, or the one
that was filed is incorrect or incomplete, for the following unit(s): _______________
The IRS is incorrect or incomplete because:
( ) The base or initial rent listed is incorrect. The correct amount is: ___________________
( ) The date first rented is incorrect. The correct date is: ____________________________
( ) The following information is missing: ________________________________________
( ) Other (Explain): _________________________________________________________
___________________________________________________________________________
( )
3. Registration Fees: The landlord has not paid registration fees and/or penalties for the
following year(s) for the following unit(s): ________________________________________
___________________________________________________________________________
6.
Additional Facts: Please state below any additional facts related to the non-registration of your unit.
Attach a separate sheet, if needed: _______________________________________________________
___________________________________________________________________________________
7.
Certification: I declare under penalty of perjury of the laws of the State of California that the
information in this petition and any attachments is true and correct to the best of my knowledge and
belief.
Signature
Date
_________________________________________________
____________________
Printed Name
_______________________________________________
Signature
Date
_________________________________________________
____________________
Printed Name
_______________________________________________
Signature
Date
_________________________________________________
____________________
Printed Name
_______________________________________________
Signature
Date
_________________________________________________
____________________
Printed Name
_______________________________________________
NOTE: All signatures must be original and all petitioning tenants must sign the Certification.
2
J:\HEARFRMS\ RWNPET.doc
10/28/05
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Pto/sb/64a - Petition For Revival Of An Application For Patent Abandoned For Failure To Notify The Office Of A Foreign Or International Filing (37 Cfr 1.137(f))
Legal
Petition For Revival Of An Application For Patent Abandoned For Failure To Notify The Office Of A Foreign Or International Filing - Us Department Of Commerce
Legal
Form Pto/sb/64 - Petition For Revival Of An Application For Patent Abandoned Unintentionally Under 37 Cfr 1.137(a) Note: A Petition For Revival To Accept The Late Payment Of Issue Fee May Alternatively Be Filed As A Web-based Epetition
Legal
Related Categories
Parent category: Legal