CORRESPONDENCE - 12/31/20

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                          Cr Mp - O84 ~C

: Form Approved
ee OMB Control No. 0920-1303
~ Expiration Date: 12/31/2020

a:
ca, am ; ‘Se 2 [FORM] DECLARATION UNDER PENALTY OF PERJURY FOR
\SENTERS FOR DISEASE CONTROL AND PREVENTION’S TEMPORARY
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L this El is for tenants, lessees, or residents of residential properties who are covered by the
rCDC’ Sor: fSemporarily halting residential evictions (not including foreclosures on home
hort: ) toieavent the further spread of COVID-19. Under the CDC’s order you must provide a
copy ofthis declaration to your landlord, owner of the residential property where yor five, or other
person who has a right to have you evicted or removed from where you live. Each adult listed on the
lease, rental agreement, or housing contract should complete this declaration. Unless the CDC order
is extended, changed, or ended, the order prevents you from being evicted or removed from where
you are living through December 31, 2020. You are still required to pay rent and follow all the ot…