AccessAndrews.com

Date:________________________

To: [Provide Applicant/Resident’s Name & Address]

Dear Applicant or Resident:

We have received your request for reasonable accommodation. Specifically, you requested [describe specific accommodation request(s)]. Following our review of your request, we have denied your request for the following reason(s):

_____You do not meet the definition of a "qualified individual with a disability" as explained in the "Reasonable

Accommodation Policy" and, therefore, we are not required to provide you with a reasonable accommodation.

_____We have determined that your request is not "reasonable" for the following reasons: [describe specific basis

for unreasonable determination]__________ _______________________________________________________________

______________________________________________________________________________________________________

______________________________

_____Your requested accommodation is structurally infeasible for the following reasons: [describe reasons for structural infeasibility determination.]_______________________________________________________________________________________________________

_____________________________________________________________________________________________________

_____Your requested accommodation would result in a fundamental alteration in the nature of our program for the

following reasons: [describe reasons for fundamental alteration determination.]________________________________

______________________________________________________________________________________________________

________________________________________________________________________________________________

_____Your requested accommodation would result in an undue financial and administrative burden for the PHA

for the following reasons: [describe reasons for undue financial and administrative burden determination.]_____ __________________________________________________________________ ______________________________________________________________________________________________________

________________________________________________________________________________________________

_____ Although we were unable to approve your specific reasonable accommodation request(s) for the foregoing reason(s), we would like to meet with you to discuss an equally effective accommodation that may meet your needs, we would like to propose the following alternate, reasonable accommodation: [describe alternate, proposed reasonable accommodation(s)]_________________________________________________________________________________________________________

__________________________________________________________________________

If you would like to discuss the alternate, proposed accommodation(s), we would like to meet with you to discuss an equally effective accommodation that may meet your needs. You may bring a friend, advocate or attorney with you to meet with us. We would like to meet with you on [insert date, time and location, including address, of proposed meeting.] If you are unable to meet with us at this scheduled time, please contact our office at [provide office telephone number] to reschedule a mutually convenient date and time for the meeting. If you disagree with our decision, you may contact Public Housing Authority Section 504/Coordinator at [provide name,

address, telephone number of Section 504/ADA Coordinator.]

In addition, you may exercise your right to appeal a PHA decision through your local HUD office or the U.S. Department

of Justice. You may contact the local HUD office at:

U.S. Department of Housing and Urban Development

HUB Office

Address

City/State/Zip Code

Telephone: ( )

Facsimile: ( )

TDD/TTY Number:

Sincerely,

Name/Title

Public Housing Authority