PETITION TO REQUEST MEDIATION OF LOT RENT INCREASE by jD0fQI

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									                   PETITION TO REQUEST MEDIATION OF LOT RENT INCREASE

             This form must be filed with the Park Owner and with the Commissioner of the Vermont
   Department of Economic, Housing and Community Development within 15 business days after the
   receipt of the notice. It is recommended that you send it by certified mail. The Commissioner’s
   copy should be addressed: Commissioner of the Department of Economic, Housing and Community
   Development, DEHCD, 1 National Life Drive, 6th Floor, Montpelier, VT 05620-0501, or you may
   fax it to 802-828-3258.
             The park owner’s address should be on the rent increase notice you received.

                                     PETITION FOR MEDIATION
         We, the undersigned, as a majority of the residents of ___________________________Mobile
Home Park, hereby notify the Commissioner of the Vermont Department of Housing and Community
Affairs and ____________________________(park owner) that we dispute the proposed lot rent increase,
and that we request mediation. We hereby authorize __________________________________ to be our
representative during the mediation process. S/He can be reached at the following:


Mailing Address                                      Phone


Town, State, Zip                                     Fax/Email, if available

Signed by the following residents of the park:

Signature                                        Printed Name                       Date        Lot #




Lot Rent Increase Form Updated 8/11/11

								
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