Request for Information Under Section 37.9(I)(4) and (J)(3) of the San Francisco Residential

Request for Information Under Section 37.9(i)(4) and (j)(3) of the San Francisco Residential Rent Stabilization and Arbitration Ordinance

Address:______Unit Number: ______

This is a request for information under Section 37.9(i)(4) and (j)(3) of the San Francisco Residential Rent Stabilization and Arbitration Ordinance. That section provides that within 30 days of service on you of this request for information, you must submit a statement, along with supporting evidence, to the landlord if you claim to be a member of one of the classes protected by Section 39.7(i) or (j). Failure to submit a statement to your landlord with supporting evidence within the 30-day period shall be deemed an admission that you are not protected by Section 37.9(i) or (j).

Section 37.9(i) of the San Francisco Residential Rent Stabilization and Arbitration Ordinance states that certain tenants cannot be evicted from occupancy of their units for use by an owner or his or her relatives. The tenants who are protected are: (1) tenants who are 60 years of age or older and have resided in the unit for 10 years or more, (2) disabled tenants who have resided in the unit for 10 years or more, and (3) catastrophically ill tenants who have resided in the unit for 5 years or more. You are disabled if you are disabled or blind within the meaning of the federal Supplemental Security Income/California State Supplemental Program (SSI/SSP) and are determined by SSI/SSP to qualify for that program or you satisfy such requirements through any other method of determination as approved by the Rent Board. You are catastrophically ill if you are disabled and your primary care physician certifies that you suffer from a life-threatening illness.

Section 37.9(j) of the San Francisco Residential Rent Stabilization and Arbitration Ordinance protects tenants who have a custodial relationship with a child under the age of 18, the tenant with the custodial relationship has resided in the unit for 12 months or more, and the effective date of the notice of termination of tenancy falls during the school year. The school year is defined as the first day of instruction for the Fall Semester through the last day of instruction for the Spring Semester, as posted on the San Francisco Unified School District website for each year.

1. Do you claim to be a member of one of the protected classes of tenants described above?

No______Yes ______

If you answer yes, please briefly state the basis of that claim and attach supporting evidence.

______

2. Do you believe that, within the next twelve months, you will become a member of one of the protected classes of tenants described above (for example, you have an application for SSI or SSP pending, you will turn 60 years of age within the next 12 months, or similar circumstances)?

No______Yes______

If you have answered yes, please briefly state the basis of that claim and attach supporting evidence.

______

I understand that the landlord will rely on this Request for Information.

I declare under penalty of perjury under the laws of the State of California that the foregoing statements are true and correct.

Signature:______Date: ______

Print Name: ______