Sample Letter/Request for Reasonable Accommodation

Date _____________________________

Landlord’s Name ___________________
Address __________________________ __________________________________

Dear _____________________________ :

I am your tenant at _______________________________. I qualify as a disabled person according to the Fair Housing Act and the Pennsylvania Human Relations Act.

I am requesting a reasonable accommodation in order to have an equal opportunity to use and enjoy my apartment. I believe the reasonable accommodation will __________________________. Housing providers are required to make “reasonable accommodations in rules, policies, practices, or services, when such accommodations may be necessary to afford [a disabled] person equal opportunity to use and enjoy a dwelling.” The Fair Housing Act, 42 U.S.C. §3604 and/or the Pennsylvania Human Relations Act, 43 P.S. §955(h)(3.2).

I am requesting the following accommodation: ___________________________________.
I need this accommodation because:___________________________________________ ___________________________________________________________________________ ___________________________________________________________________________.

Please respond to my request in writing within ten (10) days. You may not inquire as to the nature or severity of my disability.

Sincerely, 

(Signature) ________________________
Date _____________________________

Name ____________________________
Address __________________________ __________________________________
​Telephone_________________________