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The City of Portland, Oregon

Portland Housing Bureau

Solving the unmet housing needs of the people of Portland.

Phone: 503-823-2375

fax: 503-823-2387

421 SW 6th Avenue, Suite 500, Portland, OR 97204

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RELOCATION EXEMPTION APPLICATION (REA) FORM

Relocation Exemption Application (REA) Form to claim Exemption from the obligation to pay city Relocation Assistance as specified in Portland City Code 30.01.085.

In response to COVID-19, there are eviction moratoriums that may prohibit a landlord from issuing terminations without a tenant-based cause. See more information about COVID-19 landlord-tenant policy responses.

Before starting the form, please read the general instructions. Review the exemption description below to confirm it matches your eligibility. To select a different exemption form, follow the link to return to the exemption list.

EXEMPTION 3: Duplex

“Tenants that occupy one Dwelling Unit in a Duplex where the Landlord's Principal Residence is the second Dwelling Unit in the same Duplex.”

The following Administrative Rules and process apply to Exemption 3:

  • The Landlord must submit the required REA Form to PHB.

  • The Landlord must receive an Acknowledgment Letter issued by PHB. An Acknowledgement Letter does not exempt a Landlord from complying with all relevant notice requirements.

  • For Rental Agreements beginning after March 8, 2018, the Landlord must provide a copy of all pages of the Acknowledgment Letter issued by PHB to the Tenant prior to the Tenant entering into a Rental Agreement for the exempted Dwelling Unit.

  • In addition to providing the Acknowledgment Letter, as described above, the Landlord must also provide a copy of all pages of the Acknowledgement Letter to the Tenant, including a description of a Tenant's Rights and Obligations, prior to each and any Triggering Event.

  • This Exemption is effective so long as an Owner of the Dwelling Unit’s Principal Residence is the second Dwelling Unit in the same Duplex as the exempted Dwelling Unit for the 6 months prior to a Triggering Event.

  • Existence of a Duplex must be independently verifiable by means of public record.

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Relo Exemption 3

STEP ONE: DOCUMENTATION GUIDANCE

This exemption requires supporting documentation.
What must be demonstrated: The Owner of the Dwelling Unit's Principal Residence is currently the second Dwelling Unit in the same Duplex as the Dwelling Unit where the Exemption is claimed. Documentation provided must include all the following features:

  • Must be dated no more than 90 days prior to the date the REA Form is submitted

  • Must be addressed to the Owner of the Dwelling Unit (by name) at the address shown in the REA Form as the Owner’s Principal Residence.
    Note:  Existence of a Duplex at that address must be independently verifiable through public records. The address for the Dwelling Unit for which Exemption is claimed must be in the same Duplex as the Owner’s Principal Residence.

  • Must conclusively demonstrate that the Owner personally resides at that address, as opposed to owning or managing the property.

    • Examples of documents that demonstrate Principal Residence, as opposed to ownership/management, include but are not limited to the following: documents from an Internet Service Provider (ISP) account, cable, and satellite bill; document from an employer, school, healthcare provider, insurance agency (unrelated to the property), a financial institution (unrelated to the property), or governmental entity (unrelated to the property).

    • Documents related to ownership or management of the Duplex, which do not conclusively demonstrate that the Owner personally resides at the Duplex, include: utility bills, property tax statements, homeowners/rental unit insurance, HOA fees, documents relating to financing of the Duplex, invoices for maintenance and repair of the Dwelling Units, and similar items.

STEP TWO: LANDLORD INFORMATION

Who is the Owner/Landlord of the Duplex?

Note: Acknowledgment Letters are issued in the legal name(s) of the property Owner(s)

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What is the address of the Duplex Owner's Principal Residence?

Note: Principal Residence means the primary location a person inhabits. It is the Dwelling Unit that is physically occupied and personally used for overnight sleep more than any other Dwelling Unit during the period of time specified in each exemption.

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e.g. 1120 SW 5TH or 5TH AND MAIN
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STEP THREE: DWELLING UNIT INFORMATION

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Which of the following best describes the ownership of the Duplex?
The Duplex is owned by:
What is the address of the Dwelling Unit for which the exemption is being claimed?
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e.g. 1120 SW 5TH or 5TH AND MAIN
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STEP FOUR: RENTAL AGREEMENT INFORMATION

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This exemption will be applied to:
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When did the tenancy/Rental Agreement originally begin?

STEP FIVE: CERTIFICATIONS & ACKNOWLEDGEMENTS

Note: This REA Form is not complete unless all sections of the form are completed, the certifications and acknowledgment statements below are certified/acknowledged, the form is signed and dated, and any required documentation is attached.

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I hereby certify that my Principal Residence is currently the second Dwelling Unit in the same Duplex as the exempted Dwelling Unit.
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I acknowledge that my Principal Residence was the second Dwelling Unit in the same Duplex as the exempted Dwelling Unit for the entirety of the six months prior to the Triggering Event.
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I acknowledge that exemption from obligation to pay city Relocation Assistance as required under PCC 30.01.085 does not extend to the notification requirements of that same section of City Code, nor does it exempt a Landlord from the limitations and obligations of any other applicable local, state or federal law. I understand that acknowledgment of my claim of exemption is not authorization for any action or inaction that is inconsistent with all applicable rules and laws.
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I hereby certify that all information provided by me in the REA form and/or provided in supporting documentation is current, true and complete to the best of my knowledge. I understand that I must inform the Portland Housing Bureau immediately and in writing of any changes. I understand that a Landlord that fails to comply with any of the requirements set forth in PCC 30.01.085 shall be liable to the Tenant for an amount up to three times the monthly Rent as well as actual damages, city Relocation Assistance, reasonable attorney fees, and costs.
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(Maximum file size: 30MB)
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