Perso

ns w

ith di

sabil

ities

are p

rote

cted

by th

e Fair

Hou

sing A

ct. A

disa

bility

is

defin

ed as

any i

mpa

irmen

t tha

t sign

ifica

ntly

limits

a m

ajor l

ife ac

tivity

su

ch as

walk

ing, s

eeing

, hea

ring,

spea

king,

brea

thing

, lear

ning,

and w

orkin

g. In

addit

ion to

phys

ical d

isabil

ities

, pro

tect

ion ex

tend

s to t

hose

with

men

tal a

nd

emot

ional

disab

ilities

as w

ell.

In or

der f

or a

perso

n with

a dis

abilit

y to f

ully u

se an

d enjo

y the

ir ho

me,

they

may

re

quire

chan

ges t

o an a

partm

ent o

r hou

se. D

epen

ding o

n the

situ

ation

, a ho

using

pr

ovide

r may

be re

quire

d to a

llow

or pr

ovide

for s

uch c

hang

es.

• Re

ason

able

Acco

mm

odat

ion

A ch

ange

in a

rule,

polic

y, pr

actic

e, or

serv

ice is

a re

ason

able

acco

mm

odat

ion. E

xam

ples i

nclud

e: all

owing

an as

sista

nce

anim

al wh

en pe

ts ar

e not

allow

ed, c

reat

ing a

rese

rved

park

ing

spac

e for

a te

nant

with

a dis

abilit

y, or

requ

estin

g a gr

ound

flo

or re

siden

ce du

e to l

imite

d mob

ility.

Any m

inim

al co

sts as

socia

ted w

ith a

reas

onab

le ac

com

mod

ation

are

gene

rally

abso

rbed

by th

e lan

dlord

.

• Re

ason

able

Mod

ifica

tion

A st

ruct

ural

chan

ge, o

r an a

ltera

tion o

f the

pr

emise

s, is

a rea

sona

ble m

odifi

catio

n. Ex

ample

s inc

lude:

insta

llatio

n of g

rab b

ars,

ram

ps, o

r low

ered

co

unte

rtops

. Cos

ts fo

r rea

sona

ble m

odifi

catio

ns ar

e ge

nera

lly pa

id by

the t

enan

t, bu

t hou

sing p

rovid

ers

rece

iving

fede

ral f

undin

g are

requ

ired t

o abs

orb

th

e cos

t.

Am I

entit

led to

chan

ges n

eede

dto

live i

n my r

ente

d apa

rtmen

t or h

ouse

?

Gene

rally

, a la

ndlor

d may

NO

T ask

...•

“How

seve

re is

your

disa

bility

?”•

“May

I hav

e per

miss

ion to

see y

our m

edica

l rec

ords

?”•

“Hav

e you

ever

been

hosp

italiz

ed be

caus

e of a

men

tal d

isabil

ity?”

• “H

ave y

ou ev

er be

en in

a dr

ug re

habil

itatio

n pro

gram

?”•

“Do y

ou ta

ke m

edica

tions

?”•

“Why

do yo

u rec

eive S

SI?”

REQUEST FOR AN ACCOMMODATION OF A HOUSING POLICY

I qualify as an individual with a disability as defined by federal and state fair housing laws. You have a policy, rule, or procedure that (prohibits) (requires) __________________________________________________________ in your building located at _____________________________________________________________________________________________________________________________.

Because of my disability, that policy would restrict my ability to use and enjoy an apartment in that building.

In accordance with my rights under federal and state fair housing laws, I am requesting that you make an accommodation

of your policy, rule, or procedure and allow me to _________________________________________________________________________. Please respond in writing, within 10 working days, to my request for the above accommodation.

Thank you for your attention to this important matter.

Signature: _____________________________________________________________________ Date_____________________

A lan

dlord

may

NO

T ref

use t

o offe

r you

the r

enta

l ag

reem

ent h

e offe

rs ot

hers:

• “P

eople

who

use w

heelc

hairs

dam

age a

partm

ents.

You h

ave

to le

ave a

doub

le se

curit

y dep

osit.

”•

“You

can o

nly liv

e her

e if t

here

is so

meo

ne to

take

care

of yo

u.”

A lan

dlord

may

NO

T ref

use t

o ren

t to y

ou, s

ayin

g, fo

r ins

tanc

e:•

“I ca

nnot

rent

to yo

u. I a

m af

raid

of fu

ture

liabil

ity, if

you g

et si

ck.”

• “I

don’t

wan

t som

eone

with

a dis

abilit

y livi

ng in

my b

uildin

g.”•

“Sor

ry, t

here

are n

o apa

rtmen

ts av

ailab

le.” (

If an

apar

tmen

t is a

vaila

ble.)

• “I

do no

t allo

w pe

ople

to liv

e in m

y apa

rtmen

ts wi

th 24

-hou

r per

sona

l

care

atte

ndan

ts.”

Any r

eque

st fo

r a re

ason

able

acco

mm

odat

ion or

mod

ifica

tion s

hould

be m

ade b

y or

on be

half

of a

perso

n with

a dis

abilit

y. Th

is ca

n be d

one a

t any

tim

e, eit

her d

uring

th

e app

licat

ion pr

oces

s or w

hile b

eing a

tena

nt.

A re

ques

t can

be m

ade o

rally

or in

writ

ing, b

ut it

is re

com

men

ded t

hat y

ou pu

t you

r re

ques

t in w

riting

to av

oid m

isund

ersta

nding

s. Yo

ur la

ndlor

d may

have

a po

licy i

n pla

ce to

addr

ess s

uch r

eque

sts.

At th

e righ

t of t

his p

age w

e hav

e at

tach

ed a

requ

est f

or re

ason

able

acco

mm

odat

ion fo

rm th

at yo

u m

ay co

mple

te an

d pro

vide t

o yo

ur la

ndlor

d.

If yo

u wou

ld lik

e fur

ther

help,

ple

ase c

onta

ct To

ledo F

air

Hou

sing C

ente

r at 4

19-2

43-6

163

or vi

sit ou

r web

site a

t to

ledofh

c.org

.

“Onc

e we a

ccep

t our

limits

, we

go be

yond

them

.” –

Albe

rt Ei

nste

in

ousin

g pro

vider

s are

requ

ired t

o allo

w ac

com

mod

ation

s and

m

odific

ation

s, as

long

as th

ey ar

e rea

sona

ble an

d are

being

requ

este

d by a

qu

alifie

d ind

ividu

al. E

ach r

eque

st sh

ould

be ev

aluate

d on a

case

-by-

case

basis

.W

hat m

ay I

be re

quire

d to p

rovid

e whe

n req

uesti

ng a

reas

onab

le ac

com

mod

ation

or m

odifi

catio

n?A

hous

ing pr

ovide

r may

requ

est t

he fo

llowi

ng in

form

ation

relat

ed to

yo

ur di

sabil

ity:

• Ve

rifica

tion o

f the

quali

fied d

isabil

ity•

Des

cript

ion of

the n

eede

d acc

omm

odat

ion/m

odifi

catio

n•

Relat

ionsh

ip be

twee

n the

disa

bility

and t

he ne

ed fo

r the

acco

mm

odat

ion/

mod

ifica

tion

This

infor

mat

ion sh

ould

only

be re

ques

ted i

f eith

er th

e disa

bility

, or t

he ne

ed fo

r th

e acc

omm

odat

ion/m

odifi

catio

n, is

not k

nown

or ob

vious

. Ve

rifica

tion o

f the

disa

bility

or ne

ed fo

r acc

omm

odat

ion/m

odifi

catio

n can

be

prov

ided b

y a m

edica

l or s

ocial

serv

ice pr

ofes

siona

l, fam

ily m

embe

r, or

othe

r re

liable

third

party

. H

ousin

g pro

vider

s gen

erall

y can

not a

sk yo

u to p

rovid

e det

ailed

med

ical r

ecor

ds or

inq

uire a

bout

the n

atur

e or s

ever

ity of

your

disa

bility

. Ca

n a ho

usin

g pro

vider

deny

my r

eque

st?A

hous

ing pr

ovide

r may

deny

a re

ques

t if t

hey c

an de

mon

strat

e:•

Ther

e is n

o disa

bility

-rela

ted n

eed f

or th

e acc

omm

odat

ion/m

odifi

catio

n•

Prov

iding

the r

eque

sted a

ccom

mod

ation

/mod

ifica

tion w

ould

caus

e:o

An un

due fi

nanc

ial or

adm

inistr

ative

burd

en; o

ro

A fu

ndam

enta

l alte

ratio

n of t

he pr

ovide

r’s op

erat

ions

If a h

ousin

g pro

vider

refu

ses y

our r

eque

st be

caus

e it i

s not

reas

onab

le, th

ey

shou

ld dis

cuss

alter

nativ

e opt

ions w

ith yo

u in o

rder

to fi

nd a

solut

ion th

at

effec

tively

addr

esse

s you

r disa

bility

-rela

ted n

eed.

This

is kn

own a

s the

in

tera

ctive

proc

ess.

If yo

u are

unab

le to

reac

h an a

gree

men

t, or

if yo

u exp

erien

ce an

undu

e dela

y in

resp

onse

to yo

ur re

ques

t, ple

ase c

onta

ct us

for a

ssista

nce.

H

Do You Have a Disability?

Do You Need Special

Living Arrangements?

Toledo Fair Housing Center

432 N. Superior

Toledo, OH

43604-1416419-243-6163toledofh

c.org

Contact us for further information:

CERTIFICATION OF STATUS AS AN INDIVIDUAL WITH A DISABILITYAccording to federal civil rights laws, the definition of disability includes:

“...with respect to a person, a physical or mental impairment which substantially limits one or more major life activities, a record of such an impairment; or being regarded as having such an impairment...

“...physical or mental impairment includes: (1) any physiological disorder or condition, cosmetic disfigurement, or anatomical loss affecting one or more of the following body systems: neurological; musculoskeletal; special sense organs; respiratory, including speech organs; cardiovascular, reproductive, digestive; genito-urinary; hemic and lymphatic; skin, and endocrine; or (2) any mental or psychological disorder, such as mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities...

“...the term ‘physical or mental impairment’ includes, but is not limited to, such diseases and conditions as orthopedic, visual, speech and hearing impairment, cerebral palsy, autism, epilepsy, muscular dystrophy, multiple sclerosis, cancer, heart disease, diabetes, Human Immunodeficiency Virus infection, mental retardation, emotional illness, drug addiction (other than addiction caused by current, illegal use of a controlled substance) and alcoholism.”

As a medical/social service professional with knowledge necessary to make such a determination, I certify that ___________________________qualifies as an individual with a disability as defined above. (IMPORTANT: Do NOT reveal the specific NATURE OR SEVERITY of the individual’s disability).

Certifying Individual: ______________________________________________________________ Date:_____________________• Race • Sex • Religion

• Color• Familial Status• Sexual O

rientation*

*Local Protection

• National Origin

• Disability• M

ilitary Status**

**State Protection

Toledo Fair Housing Center

VisionThe Fair H

ousing Center will be a leading visible force in preventing and correcting discrim

inatory practices. M

issionThe Fair H

ousing Center is a non-profit civil rights agency dedicated to the elimination

of housing discrimination, the prom

otion of housing choice and the creation of inclusive com

munities of opportunity. To achieve our m

ission, the Center engages in education and outreach, housing counseling, advocacy for anti-discrim

inatory housing policies, research and investigation and enforcem

ent actions.

The Fair Housing Act Protects You

Creating Inclusive Comm

unities of Opportunity

The Fair Housing Act m

akes it illegal to discrim

inate against someone because of their:

Discrimination during tenancy m

ay include:•

Requiring people with mobility im

pairments to live in ground-floor units.

• Segregating people with disabilities in a particular building or portion of an apartm

ent complex.

• Refusing to respond to m

aintenance calls, or responding more slowly,

because of a tenant’s disability.•

Banning people with disabilities from pools, clubhouses, or other

com

mon areas.

• Charging extra fees for m

aintenance calls made by people

with disabilities.

• Refusing to renew the lease of a person with a disability, when the leases of people without disabilities are routinely renewed.

• Threatening or intim

idating remarks or conduct by m

anagement or by other

tenants directed at a person with a disability.

A reasonable modification could be:

• Installing an autom

atic water faucet shut-off for people who can’t remem

ber to turn off the water.

• Installing a ram

p to make a prim

ary entrance accessible for people with a m

obility disability.•

Installing pictures, color-coded signs, or pathways for people whose cognitive disabilities m

ake written signs im

possible to use.•

Installing carpeting or acoustic tiles to reduce noise m

ade by a person whose disability causes him

or her to m

ake a lot of noise.•

Disconnecting a stove and

installing a microwave for a person

unable to operate a stove safely.

The work that provided the basis for this publication was supported by funding under a grant with the U.S. Departm

ent of Housing and Urban D

evelopment.

The substance and findings of the work are dedicated to the public. The author and publisher are solely responsible for the accuracy of the statements and

interpretations contained in this publication. Such interpretations do not necessarily reflect the views of the Federal Government.