Inglewood, CA · Los Angeles County
Owner’s Affidavit (Tenant Refusal)
This affidavit is for property owners who document that a former tenant declined or did not respond to an offer to return to a rental unit.
What this form is
An owner uses this affidavit to record efforts to contact a former tenant and offer the rental unit back at the same rent. It asks for the rental property address, contact information used, and the date the tenant declined, if applicable; the owner also acknowledges the rent requirement for a new tenant and declares the information true under penalty of perjury.
Who needs it
A property owner uses this affidavit when documenting efforts to offer a rental unit back to a former tenant who declined or did not respond.
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 document is signed without a notary; the owner makes a declaration under penalty of perjury and signs and dates the form.
How to submit this form
- 1
Download The Affidavit
Download the Owner’s Affidavit (Tenant Refusal) PDF.
- 2
Complete The Form
Enter the owner and rental unit information, tenant contact details, and the date of any refusal.
- 3
Review The Declaration
Confirm the information is accurate; the owner declares it true under penalty of perjury.
- 4
Sign And Submit
Sign and date the form, then submit it to the city department named on the form.
Frequently asked questions
- What does the Owner’s Affidavit (Tenant Refusal) document?
- It records an owner’s efforts to contact a former tenant and offer the rental unit back at the same rent, including the tenant’s refusal or lack of response.
- Who completes this affidavit?
- The property owner completes it, providing the rental unit address, tenant contact details, and the date the tenant declined the offer, if applicable.
- Do I need a notary for the Owner’s Affidavit (Tenant Refusal)?
- No. The form has no notary block; the owner signs and dates it and declares the information true under penalty of perjury.
- How do I submit the Owner’s Affidavit (Tenant Refusal)?
- The form does not give submission instructions. Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This Owner’s Affidavit (Tenant Refusal) doesn’t need a notary — but if you have another Inglewood form that does, a commissioned online notary can help.