Stop Debt Collector Harassment with Accommodation Request Letter

Please answer the questions below to generate a letter you can send to your landlord.

After you answer the questions and click "Click here to get your letter," your letter will appear. If you don't complete the required fields, your letter won't appear until you do so.

Once your letter appears, download it and then send it to your landlord.

This accommodation request generator will NOT send the request to your landlord. You MUST download the letter and send it to your landlord.

Languages: this Accommodation Request to Stop Debt Collector Harassment Tool is available in English and Spanish. Be aware that DRTx recommends that you provide your request in a language understandable to the party or entity receiving it, which in most circumstances will be English.

"*" indicates required fields

My Current Contact Information

Name * Required

First Last

Address * Required

Street Address Address Line 2 City State ZIP Code

Preferred Contact Method * Required

What is the best way for your landlord to contact you? We recommend either communicating in writing (mail or email) or having a witness.

Mail (using the address provided above)

Email Address * Required

Name and Address where the Debt Collector says you owe money.

Old Landlord's Name (if you know it)

Full Name or Company Name

Your Old Address * Required

Street Address Address Line 2 City State ZIP Code

Date you requested an accommodation from the landlord to terminate lease early with no fees, fines, or penalties. * Required

If you have not done this yet, please use our Request Early Lease Termination tool.

MM slash DD slash YYYY

The Debt Collector's Contact Information

Please provide the debt collectors full name or company name and a contact email address and/or mailing address.

Debt Collector's Name * Required

Full Name or Company Name

Debt Collector's Mailing Address

Street Address Address Line 2 City State ZIP Code

Debt Collector's Email Address

About my Circumstances

Because of what is happening, which of the following has become harder to do? * Required

Check all that apply

Breathe

Work

Focus

Sleep

Eat

Leave my home

Interact with others

Other effect

Other effects * Required

Please specify what other things have become harder to do.

I need the accommodation because * Required

Check all that apply

I cannot secure permanent housing which increases the chances that I will get exposed to COVID-19 which the CDC has said puts people like me at risk of serious disease resulting in hospitalization, admission to the ICU, intubation or mechanical ventilation, or death

We cannot secure permanent housing which increases the chances that someone that lives with me will get exposed to COVID-19 which the CDC has said puts people like them at risk of serious disease resulting in hospitalization, admission to the ICU, intubation or mechanical ventilation, or death

I am unable to have my necessary medical equipment with me because I do not have stable housing

Someone that lives with me is unable to have their necessary medical equipment because we do not have stable housing

The symptoms of my disability are worse because I cannot get stable housing

The symptoms of someone in my household’s disability are worse because we cannot get stable housing

I am homeless and at risk of serious disease if exposed to COVID 19 because landlords will not rent to me with the alleged debt showing which increases the chances that I will end up hospitalized, admitted to the ICU, intubated or on mechanical ventilation, or dead

We are homeless and at risk serious disease if exposed to COVID 19 because landlords will not rent to us with the alleged debt showing which increases the chances that the person in our household that is at risk of serious disease will end up hospitalized, admitted to the ICU, intubated or on mechanical ventilation, or dead

I am living with other people because landlords will not rent to me with the alleged debt showing up which increases the chances that I will end up hospitalized, admitted to the ICU, intubated or on mechanical ventilation, or dead because I am at risk of serious disease if I’m exposed to COVID-19.

We are living with other people because landlords will not rent to us with the alleged debt showing up which increases the chances that that the person in our household that is at risk of serious disease will end up hospitalized, admitted to the ICU, intubated or on mechanical ventilation, or dead.

Moving around from place to place while searching for permanent housing is exposing me to COVID-19 which the CDC has said puts me at risk of serious disease resulting in hospitalization, admission to the ICU, intubation or mechanical ventilation, or death.

Moving our family around from place to place while searching for permanent housing would expose someone in our family to COVID-19 which the CDC has said puts people like them at risk of serious disease resulting in hospitalization, admission to the ICU, intubation or mechanical ventilation, or death.

Request a Response

Request a response from the landlord by a certain date. The more time sensitive the issue, the less time you would give. Generally speaking, two weeks to respond should be enough.

Date * Required

Month

Day

Year

Signature

If you have questions, please reach out to us or your local Legal Aid office.

Additional Information

Thank you for answering the following optional questions to help us ensure we reach a diverse group of Texans with disabilities.

What is your age?

Gender

Please select the gender you identify with.

Female

Male

Other

Please specify the gender you identify with.

Race

Please select the race you identify with.

American Indian/Alaskan Native

Asian

Black/African American

Native Hawaiian/Other Pacific Islander

Race Unknown

Two or more races

White

National origin/ethnicity

Hispanic/Latino

Not Hispanic/Latino

Are you a veteran?

Yes

Household Income

What is the total income for your household in one year?

Household members

How many people are in your household?

Name

This field is for validation purposes and should be left unchanged.

Publication Code: HS14

Disability Rights Texas logo

www.DRTx.org
Statewide Intake: 1-800-252-9108
Sign Language Video Phone: 1-866-362-2851
Purple 2 Video Phone: 512-271-9391
Online Intake available 24/7: intake.DRTx.org

Disclaimer: Disability Rights Texas strives to update its materials on an annual basis, and this handout is based upon the law at the time it was written. The law changes frequently and is subject to various interpretations by different courts. Future changes in the law may make some information in this handout inaccurate.

The handout is not intended to and does not replace an attorney’s advice or assistance based on your particular situation.

To request this handout in ASL, Braille, or as an audio file, contact us.

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My Current Contact Information

Name and Address where the Debt Collector says you owe money.

The Debt Collector's Contact Information

About my Circumstances

Request a Response

Additional Information

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