Do I need a notary for the ADUP Annual Affordable Rent Certification?

No. The owner and occupant sign declarations under penalty of perjury, but the form does not require notarization. Include a copy of the written lease if there is one.

How do I submit the ADUP Annual Affordable Rent Certification?

Submit it with the owner’s application for or renewal of the City’s business license. The form also calls for submission when occupancy or household composition changes.

When is this certification required?

Complete it annually, effective each December 31, and submit it with the owner’s business license application or renewal. Submit it as well when occupancy or household composition changes.

What information does the certification request?

It requests unit, owner, rent, utility, tenant, occupant, and household income information. The owner should provide a copy of the written lease agreement, if any.

Piedmont, CA · Alameda County

No notary required

ADUP Permit Annual Affordable Rent Certification

Owners of rent-restricted accessory dwelling units complete this annual certification to report rent, utilities, household occupants, and income to the City of Piedmont.

What this form is

This form certifies annual rent and household information for a rent-restricted accessory dwelling unit. The owner submits it with an application for or renewal of the City’s business license, and when occupancy or household composition changes. It asks for the unit’s rent and utilities, owner and tenant details, occupants’ names and ages, household income, and signatures; include a copy of the written lease if there is one.

Who needs it

Owners of rent-restricted accessory dwelling units complete the certification annually and when occupancy or household composition changes.

How to submit it

Submit the certification with the Owner’s application for or renewal of the City’s business license, and when occupancy or household composition changes. The form gives no submission address or email.

About notarization

This document is signed without a notary; the owner and occupant each declare under penalty of perjury, and the owner includes a written lease copy if any.

How to submit this form

1
Download The Form
Download the ADUP Permit Annual Affordable Rent Certification PDF.
2
Complete The Certification
Provide the unit, owner, rent, utility, occupant, and household income information requested.
3
Gather The Lease
Include a copy of the written lease agreement, if any.
4
Submit To The City
Submit it with the owner’s business license application or renewal, and when occupancy or household composition changes.

Frequently asked questions

Do I need a notary for the ADUP Annual Affordable Rent Certification?: No. The owner and occupant sign declarations under penalty of perjury, but the form does not require notarization. Include a copy of the written lease if there is one.
How do I submit the ADUP Annual Affordable Rent Certification?: Submit it with the owner’s application for or renewal of the City’s business license. The form also calls for submission when occupancy or household composition changes.
When is this certification required?: Complete it annually, effective each December 31, and submit it with the owner’s business license application or renewal. Submit it as well when occupancy or household composition changes.
What information does the certification request?: It requests unit, owner, rent, utility, tenant, occupant, and household income information. The owner should provide a copy of the written lease agreement, if any.

Need something notarized?

This ADUP Permit Annual Affordable Rent Certification doesn’t need a notary — but if you have another Piedmont form that does, a commissioned online notary can help.