Fillable Self Cert Application Affidavit Rev2 (City of Hayward)

Fill Online, Printable, Fillable, Blank Self Cert Application Affidavit Rev2 (City of Hayward) Form

Use Fill to complete blank online CITY OF HAYWARD (CA) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Self Cert Application Affidavit Rev2 (City of Hayward)

On average this form takes 3 minutes to complete

The Self Cert Application Affidavit Rev2 (City of Hayward) form is 1 page long and contains:

  • 0 signatures
  • 2 check-boxes
  • 13 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Hayward

BROWSE CITY OF HAYWARD (CA) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
CODE ENFORCEMENT DIVISION - RESIDENTIAL RENTAL INSPECTION PROGRAM
SELF-CERTIFICATION APPLICATION - AFFIDAVIT
Once approved for self-certification, the owner, agent or designated representative is required to inspect the property on an annual
basis. In addition, you must complete and return the application - affidavit to the City of Hayward Rental Inspection Program. Failure
to return the application - affidavit annually will result in loss of self-certification status.
CERTIFICATION
ADDRESS:
NUMBER OF UNITS:
APARTMENT COMPLEX NAME:
INSPECTION DATE:
Owners of rental housing properties in the Self-Certification Program must certify each and every rental housing unit on
the property at least once every calendar year and upon change in tenancy. Self-Certification requires the following:
• Insp
ect each rental housing unit on the property for compliance with the checklist.
• Immediately make any repairs to the rental housing unit in order to achieve compliance with the requirements of
the checklist.
• Upon completion of the checklist, maintain a copy on file and submit the application – affidavit to the City of
Hayward Residential Rental Inspection Program.
• Immediately notify the City of Hayward Code Enforcement Division if any rental unit cannot be self-certified
because necessary repairs cannot or will not be made.
SIGNER’S NAME: (PRINT)
OWNER
OWNER’S AGENT
SIGNATURE:
SIGNER’S ADDRESS: (street number and name)
CITY:
STATE:
TELEPHONE:
BEST TIME TO CALL:
E-MAIL:
FAX:
PLEASE MAIL THE EXECUTED SELF-CERTIFICATION APPLICATION - AFFIDAVIT TO:
Cit
y of Hayward
Code Enforcement Division - Residential Rental Inspection Program
777 B Street, 1
st
Floor
Hayward, CA 94541
The signature affixed to this document certifies that the owner or agent has inspected all the units and building exteriors at the
property specified, and that this property is well maintained as detailed in the Self-Certification Checklist. Any falsification of this
document or misrepresentation of the true condition of the property is grounds for dismissal from the self-certification program.
CODE ENFORCEMENT DIVISION – RENTAL INSPECTION PROGRAM
777 B Street, Hayward, CA 94541-5007 - Tel: 510/583-4175 - Fax: 510/583-4994 - http://www.hayward-ca.gov
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Self Cert Application Affidavit Rev2 (City of Hayward)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 15 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document