Crescent City, CA · Del Norte County
Reasonable Accommodation Request
This request form lets a Crescent City housing program applicant or participant ask for a change to help a household member with a disability access and use housing programs.
What this form is
The form requests a change to a policy, practice, or procedure, or another change, so a person with a disability can fully access and use housing programs. It asks for the applicant’s contact information, the household member’s disability, the requested change and reason, and permission to contact someone who can verify the need.
Who needs it
A housing program applicant or participant may use this form to request an accommodation for a household member with a disability.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This request is signed and dated without a notary; the form lists no notarized or sworn attachment, so the applicant just signs and dates it.
How to submit this form
- 1
Download The Request
Download the Reasonable Accommodation Request PDF.
- 2
Complete The Form
Provide the requested contact information, describe the accommodation and reason, and complete the verification permission section.
- 3
Check For Attachments
The form lists no attachment to gather.
- 4
Submit To The City
Submit the completed request to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- Do I need a notary for the Reasonable Accommodation Request?
- No. The form asks the applicant or participant to sign and date it, and lists no notarized or sworn attachment.
- Who can use this request form?
- A housing program applicant or participant can request an accommodation for a household member with a disability.
- What information does the form ask for?
- It asks for contact details, information about the household member with a disability, the change requested and its reason, and permission to contact someone who can verify the need.
- How do I submit the Reasonable Accommodation Request?
- The form does not give submission instructions. Submit it to the city department named on the form and check the city website for current contact details.