The Sunset Mobile Home Park Survey

Fair Housing Advocates of Northern California is investigating potential violations of fair housing law at Sunset Mobile Home Park. All responses will be treated confidentially.

Fair Housing Advocates of Northern California está investigando posibles violaciones de la ley de vivienda justa en Sunset Mobile Home Park. Todas las respuestas serán tratadas de forma confidencial.

For general information about fair housing and/or our education services, please visit our website at www.fairhousingnorcal.org.

Para obtener información general sobre vivienda justa y/o nuestros servicios educativos, visite nuestro sitio web en www.fairhousingnorcal.org

First Name

Last Name

Today's Date (MM/DD/YYYY)

Date of Birth (MM/DD/YYYY)

5-Digit Zip / Postal Code

County

How well do you speak English?

What is your preferred language?

Annual household income?

COMPLAINTS

How long have you lived at Sunset Mobile Home Park?

Have you ever requested a reasonable accommodation from Burbank Housing?

If yes:

please describe your request (an emotional support animal, transfer to another unit, increase number of bedrooms, etc.):

When did you make the request(s)?

If you have requested a reasonable accommodation, how did you request it? Check all that apply:

Orally (in person or via phone)Via e-mailVia text messageOn Burbank Housing's Form

Who did you speak to about your reasonable accommodation request? (management, lawyer, etc.)

As a condition for granting your request, were you required to provide any additional information, documentation (such as a doctor's letter), or fill out any forms (such as a medical release or lease addendum)?

If so, what were you asked to provide?

What was the outcome of your request? Check all that apply:

GrantedDeniedIgnoredAlternative accommodation

If your requested accommodation was denied, was a reason given?

Do you have any written documentation of your correspondence regarding the reasonable accommodation request? (emails, documents provided/requested)

OTHER

Would you be interested in filing a complaint based on your experience?

Would you be interested in being a witness for another person's complaint?

Are you interested in receiving information about forming a tenant's union?

Do you have any other concerns as a tenant that you would like to share?

Were you involved in a recent lawsuit against your landlord?

Nombre

Apellido