South San Francisco, CA · San Mateo County
Advance Deposit Hardship Waiver Request
This form lets a person cited for an administrative violation ask South San Francisco to waive an advance deposit because of economic hardship.
What this form is
Use this form to request an advance deposit hardship waiver for an administrative citation from the City of South San Francisco. The request must be filed with the Finance Department secretary within 15 days of the citation date and include the requested hardship explanation, a recent income or benefit voucher, and the most recent federal tax return.
Who needs it
A person seeking an advance deposit waiver for an administrative citation because of economic hardship should complete and file this request.
How to submit it
File the request with the Finance Department secretary within 15 days of the citation date. Include a recent pay stub or listed benefit voucher and the most recent federal tax return.
About notarization
This request is signed without a notary; the signer declares under penalty of perjury that the information is true and correct, then signs and dates it.
How to submit this form
- 1
Download The Request
Download the Advance Deposit Hardship Waiver Request form.
- 2
Complete The Form
Provide your name, address, phone number, citation date and number, and explanation of economic hardship.
- 3
Gather Required Documents
Attach your most recent federal tax return and a recent pay stub or listed benefit voucher.
- 4
Sign And Submit
Sign and date the request, then file it with the Finance Department secretary within 15 days of the citation date.
Frequently asked questions
- Who can use the Advance Deposit Hardship Waiver Request?
- A person cited for an administrative violation who is claiming economic hardship can use this form to request an advance deposit waiver.
- What must I attach to the request?
- Include your most recent federal tax return and a recent pay stub, unemployment voucher, disability voucher, or welfare voucher.
- Do I need a notary for the Advance Deposit Hardship Waiver Request?
- No. The signer declares under penalty of perjury that the information is true and correct, then signs and dates the request; no notary is specified.
- How do I submit the Advance Deposit Hardship Waiver Request?
- File it with the Finance Department secretary within 15 days of the citation date, along with the listed income or benefit document and most recent federal tax return.
Need something notarized?
This Advance Deposit Hardship Waiver Request doesn’t need a notary — but if you have another South San Francisco form that does, a commissioned online notary can help.