Do I need a notary for the Owner/Close Relative’s Statement of Occupancy?

No. The form has no notary block; the signer makes a declaration under penalty of perjury that the information and attachments are true and correct.

Who uses this occupancy statement?

An owner uses it after recovering possession of a rental unit when the owner or a close relative currently occupies the unit.

What supporting documents must I attach?

For each owner or relative named, attach at least two forms of supporting documentation from the form’s list. The form says substitutions will not be accepted.

Inglewood, CA · Los Angeles County

No notary required

Owner/Close Relative’s Statement of Occupancy

Owners use this statement when they have recovered a rental unit and they or a close relative currently occupy it.

What this form is

Use this form after recovering possession of a rental unit that the owner or a close relative currently occupies. It asks about the unit, occupants, residence, and related details, and requires supporting documents for each owner or relative named. The form says to file a copy with the Inglewood Housing Protection Department within 15 calendar days of taking possession.

Who needs it

An owner who recovered possession of a rental unit and currently occupies it, or whose close relative currently occupies it, should file this statement.

How to submit it

File a copy of the form and supporting documentation with the Inglewood Housing Protection Department within 15 calendar days of taking possession.

About notarization

This document is signed without a notary; the signer declares under penalty of perjury that the information and attachments are true and correct.

How to submit this form

1
Download The Form
Download the Owner/Close Relative’s Statement of Occupancy.
2
Complete The Statement
Answer each question and provide the requested unit and occupant information; do not leave blanks.
3
Gather Supporting Documents
For each owner or relative named, attach at least two items from the form’s supporting-document list.
4
File With The Department
File a copy and the supporting documentation with the Inglewood Housing Protection Department within 15 calendar days of taking possession.

Frequently asked questions

Do I need a notary for the Owner/Close Relative’s Statement of Occupancy?: No. The form has no notary block; the signer makes a declaration under penalty of perjury that the information and attachments are true and correct.
Who uses this occupancy statement?: An owner uses it after recovering possession of a rental unit when the owner or a close relative currently occupies the unit.
What supporting documents must I attach?: For each owner or relative named, attach at least two forms of supporting documentation from the form’s list. The form says substitutions will not be accepted.
How do I submit the occupancy statement?: File a copy and supporting documentation with the Inglewood Housing Protection Department within 15 calendar days of taking possession.

Need something notarized?

This Owner/Close Relative’s Statement of Occupancy doesn’t need a notary — but if you have another Inglewood form that does, a commissioned online notary can help.