ORD 2309 - Laserfiche WebLink

JUNIOR ACCESSORY DWELLING UNIT (JADU) INCLUSIONARY UNIT ANNUAL SURVEY Please submit your completed survey electronically within 30 days to: City of Pleasanton Housing Division—housing(a.citvofpleasantonca.gov Owner Name(s): Unit Address & Development: Mailing Address: Contact Information (email & phone number): Rental and Ownership Verification Your secondary unit is a JADU Inclusionary Unit restricted for income-eligible households. To verify the maximum monthly rent a tenant may be charged and household income limits, visit: https://www.citvofpleasantonca.gov/our-qovernment/housing/housing-programs/#rental-housing YES NO 1. I am currently renting my JADU Inclusionary Unit to another household/individual. ❑ D If yes: a. Indicate the monthly rent being charged. $ b. Identify the number of persons in the tenant household. c. Indicate the annual gross income of the tenant household $ d. Provide a copy of the lease agreement to the City. 2. Provide a copy of your current homeowner's insurance to the City. I understand that there are restrictions on my property and if I choose to refinance, sell, or rent my property, I must contact the City of Pleasanton Housing Division at 925-931-5011 or at housing ac ..citvofpleasantonca._gov. I understand that, per my Secondary Unit Regulatory Agreement, if I choose to rent my JADU Inclusionary Unit, the monthly rent cannot exceed one-twelfth of thirty percent(30%) of the 80%Area Median Income (AMI), adjusted for household size, less a utility allowance as specified by the Housing Authority of the County of Alameda (HACA.net). In affixing my/our signature/s below, I/we affirm that all information provided in this form is true and correct. I/we understand that if any information is falsely reported, the City of Pleasanton may take legal action against me/us. Signature of Owner, Print Name Date Signature of Owner, Print Name Date 14