Reasonable Accommodation Letter

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Required fields are in bold.

Client's White PJ Account Numberanonymous
Date (MM/DD/YYYY)
Tenant's Name
Tenant's Address
Tenant's City
Tenant's State (two-letter abbr)
Tenant's Zip
Landlord's Name
Landlord's Address
Landlord's City
Landlord's State (two-letter abbr)
Landlord's Zip
Tenant has: physical disabilities
mental disabilities
both physical and mental disabilities
Tenant's disabilities are:
 
Tenant requests the following accommodation:
 
The accommodation is necessary because:
 



, MA



,

Dear ,

I am a tenant of yours at , , MA, .

I suffer from the following :

Because I am disabled I require a reasonable accommodation or a change in your rules or policies. I am requesting that I receive the following change in your rules or policies:

This accommodation is necessary because:

I hope to hear from you within one week of your receipt of this letter. If I do not hear from you by then, I may choose to take further action. Should you have an attorney representing you, I recommend that you forward this letter to that attorney and provide me the name of the attorney. Thank you for your assistance.

Sincerely,