Reasonable Accommodation Rent Request

Reasonable Accommodation Rent Request
Serving Dickey, Eddy, Foster, Logan, Sargent, Stutsman, and Wells Counties
REASONABLE ACCOMMODATION RENT REQUEST
Name

First NameLast Name
I request the reasonable accommodation rent request that allows for a higher rent ceiling. This request allows the housing authority to use up to 120% of the HUD fair market rent. Units cannot be upscale. Rent cannot include garage.
Tenant requires accessible unit;Tenant requires elevator access;Tenant wishes to reside in unit outside of high poverty area;Tenant requires two-bedroom for medical reasons or service animal;Tenant requires healthy unit (example: separate air systems, force air, secure entry);Household member requires separate room per medical documentation;Other
Tenant must demonstrate reasons that the financial cost benefits health and is a reasonable

accommodation. Housing Authority reserves the right to refuse the accommodation when suitable units are available, or tenant does not provide documentation.
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Mailing address: 300 2nd Ave NE - Suite 200, Jamestown, ND 58401

Toll free: 800-340-4537 Phone: 701-252-1098 Fax: 701-252-7735

Web: www.greatplainsha.com Email: office@greatplainsha.com Locations: Carrington, Ellendale, Jamestown, New Rockford
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