TENANT COMPLAINT FORM LOS ANGELES HOUSING DEPARTMENT

This form is intended to be used by the public as an easy way of submitting Rent Stabilization Ordinance complaints electronically.

Please complete the items below and select Submit.

For additional information please call 1-866-557-7368. You must be using a Forms-capable WWW client to be able to submit comments.

If your Internet browser does not allow you to submit this form, please use the pdf version or e-mail your request to: LAHD.RSO@lacity.org

Los Angeles Housing Department
Rent Stabilization Ordinance
Tenant Service Request Form

SPECIAL NOTICE:  The Rent Stabilization Ordinance (RSO) covers rental housing units within Los Angeles city limits. Telephone (213) 808-8888 or 1-866-557-RENT [7368] for more information on rental units covered by the RSO.

SUBJECT:  This complaint can be filed by any tenant who has documentation that shows that an owner/manager/agent has committed a violation of the Rent Stabilization Ordinance of the City of Los Angeles.

Please enter your information(include apartment/unit number): This information is required in order to properly process your request.  Please provide a telephone number or email address where we can reach you.

*	Your Name:
*	Address:
*	City:
*	State:	*Zip Code:
*	Phone (1):	Phone (2):
*	Email Address:

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	Owner's Name:
	Address:
	City:
	State:	Zip Code:
	Phone:

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	Manager's Name:
	Address:
	City:
	State:	Zip Code:
	Phone:

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Type of Rental Unit:

Please Select One: Duplex Apartment Mobile Hotel Guest Room/House Other

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How did you find out about the Rent Stabilization Ordinance? (Please select one of the following):

Please Select One: Hotline Television Friends Legal Aid Mailings Phonebook Newspaper Council Offices Government Other Government Agencies Other Other (please specify)

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How much is your current rent?

How many bedrooms do you have? Please Select One: 1 2 3 4 5

How many people live in your home?   Adults  Children

How long have you lived at this address? yrs. mos.

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Reason For this Complaint: Please mark the box(es) indicating the type of violation(s) that occurred.

Your rental unit is not registered. (Complete Section A below).

Notice to Quit (Eviction Notice) is based on false and deceptive grounds. (Complete Section B below).

Non-payment of Relocation Assistance. (Complete Section C below).

Illegal Rent. (Complete Section D below).

Reduction of Services. (Complete Section E below).

Failure to Post RSO Notice. (Complete Section F below).

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A. UNIT(S) NOT REGISTERED:

1) Is your unit registered? Yes  No

B. NOTICE TO EVICT BASED ON FALSE AND DECEPTIVE GROUNDS:

1) Have you received a written notice to move out? Yes  No

If yes, give date of notice Verbal notice only?

C. NON-PAYMENT OF RELOCATION ASSISTANCE FEES:

1) What reason was stated for requesting you to move?

D. ILLEGAL RENT

1) Give date when the illegal rent increase was demanded or

collected.

2) What was the amount of rent before the increase?

3) What was the amount of rent after the increase?

4) Who pays the gas and/or electricity bill for your unit?

Electricity: Please Select One: Owner Tenant Gas: Please Select One: Owner Tenant

E. ILLEGAL REDUCTION OF SERVICES:

1) What was the service that you are no longer getting?

The following does not apply to short-term service interruption.

Long-term utility service shut off? (include date the service stopped) DWP/Gas Co Shut Off Notice Received? Yes No

Water() Hot Water() Elec() Gas()

F. FAILURE TO POST RSO NOTICE:

1) Is there a RSO Notice posted on the property?

Yes No

2) Has there ever been a RSO Notification posted on this property?

Yes No

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Reset:

Submit:

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Thank you for your input. If your Internet browser does not allow you to submit this form, please use the pdf version or e-mail your request to LAHD.RSO@lacity.org

rentfrm.htm (rev 11.09.10)