Rental Assistance Discrimination Intake

Use this form for every household you know that has needed rental assistance, whether or not this assistance was applied for or paid out.

Enter information about one renter household's experience with rental assistance. Submit multiple times to submit different households. Data will be used as you direct (see radio buttons below) for:

• Examples in possible litigation MassLandlords may conduct, if you permit;
• Media appearances, if you permit; or
• Aggregate statistics only in all instances.

This form is not an application for rental assistance.

• THIS FORM WILL NOT RESULT IN OBTAINING RENTAL ASSISTANCE FOR ANYONE WHO HAS NOT ALREADY RECEIVED IT.
• A primary benefit to participating is a sworn statement entered into the public record about the ease of or difficulty in obtaining rental assistance. Your entry is not survey data. Your entry may be used by us to assert a legal claim against the Commonwealth or its agents.
• If you or a renter household need rental assistance, you should use every option available to recover rents, including re-applying for RAFT, ERMA, or other emergency subsidies in parallel.

Important legal information:

• Entry of information is subject to our terms of use and privacy policy. We will not disclose individual information except to the extent you authorize, see checkboxes below.
• Entry of information does not imply or guarantee that we will be able to recover rental assistance for you. You will not be reimbursed for your time entering data into this form.
• If we decide to use your example in our case, we will quote your example anonymously. If we wish to connect you with the media, we will obtain additional permission first. If we wish to use your name in our case, we will obtain additional permission first.

Technical information:

• This form will not save partial data unless you click "Save and continue later" and return to the link provided. You must complete all fields and click "Submit" on the final page before anything will be reviewed.
• If after submitting you need to modify your entry, do not submit the form a second time. Email hello@masslandlords.net to make a correction, withdraw your entry, or perform or any other task beyond initial submission.
• If you prefer to submit multiple households in a spreadsheet, use this template and email a copy to hello@masslandlords.net with the statement "The information attached is true and correct as of today. I submit this information with intent to sign digitally under the pains and penalties of perjury."