Ellis Act Forms

Posted: September 9th, 2018 1:02 PM

Last Updated: November 1st, 2022 12:09 PM

The Ellis Act process begins with the owner filing with the Rent Adjustment Program a series of documents called the “Withdrawal Notices." Notices must be signed by all owners of record and are subject to penalty of perjury.

These required notices consist of the following forms 1-4.

All rental units on the property must be removed through an Ellis Act withdrawal.

The filing fee is $250.00 per unit. The removal of the unit is effective 120 days after filing the Withdrawal Notices. If the tenant is sixty-two (62) years of age or older and/or disabled, the withdrawal is effective one (1) year. The Ellis Act cannot be used to withdraw a rental unit during a fixed term lease. Also, it cannot be used to retaliate or discriminate against a tenant.

Tenant households are entitled to relocation assistance. The payment amount depends on the size of the unit as explained under the Uniform Relocation Ordinance.


Form 1: Ellis Act Form 1 Notice to Rent Adjustment Program of Intent to Withdraw

Form 2: Ellis Act Form 2 Certificate and Summary of Notice of Intent to Withdraw

Form 3: Ellis Act Form 3 Notice of Interest in Re-Renting Unit

Form 4: Ellis Act Form 4 Notice to Rent Adjustment Program of Constraints

Form 5: Ellis Act Form 5 Notice Of Entitlement To Extension Of Time Terminating Tenancy To One Year Based On Disability Or Age

Form 6: Do not file this form unless no vacancy has occurred due to the Ellis Act, or will occur due to filing for an Ellis Act conversion. Ellis Act Form 6 Notice to Rent Adjustment Program of Rescission

Form 7: File this form with the Rent Adjustment Program if you plan to re-offer the withdrawn unit(s) as residential rental units. Owners must notify the RAP if they intend to rent a withdrawn property. If within ten years the unit is rented, former tenants must be offered the first chance to rent. At this point in the process, owners are highly encouraged to seek and obtain legal counsel. Ellis Act Form 7 Notice to Rent Adjustment Program of Intent to Re-Offer