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Rent Program Enrollment Form

  1. Instructions

    To assist with Measure L compliance, landlords and owners of residential Rental Units located within the City of Richmond shall annually submit the Rent Program Enrollment Form. A Rent Program Enrollment Form must be completed for EACH SEPARATE ASSESSOR’S PARCEL having a rental unit(s). You may claim exemption from classification as a Controlled Rental Unit (RMC 11.100.030(d)) using this form. All information must be submitted completely and accurately. Demanding a payment of rent in violation of RMC Chapter 11.100 is a violation of the Richmond Municipal Code and is subject to remedies set forth in RMC Chapter 11.100. All submitted information is subject to routine audit.

  2. Owner and Property Manager Information

  3. Owner (Name on Title)

  4. Property Manager

  5. Send Rent Program mail to (check all that apply): *

  6. Property Information

  7. Enter the total number of units for each unit type within the unique APN.

  8. Unit Summary (Include Only Units Associated with the Unique APN - see Q1)

  9. Individual Unit Information (Include Only Units Associated with the Unique APN - Q1)

  10. If this unique APN contains more than five units, please list ALL units in a separate Excel sheet and upload it below. Please note: only sheets in Excel format that match the fields identified below will be accepted.

  11. I wish to claim an exemption for this unit - This unit is NOT a Controlled Rental Unit (See RMC 11.100.030(d)

  12. I wish to claim an exemption for this unit - This unit is NOT a Controlled Rental Unit (See RMC 11.100.030(d)

  13. I wish to claim an exemption for this unit - This unit is NOT a Controlled Rental Unit (See RMC 11.100.030(d)

  14. I wish to claim an exemption for this unit - This unit is NOT a Controlled Rental Unit (See RMC 11.100.030(d)

  15. I wish to claim an exemption for this unit - This unit is NOT a Controlled Rental Unit (See RMC 11.100.030(d)

  16. Signature

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

  18. Signature Verification*

  19. Form Resubmission?

  20. Leave This Blank:

  21. This field is not part of the form submission.