Hrvd N Form – Fill Out and Use This PDF

State of New York	Gertz Plaza
Division of Housing and Community Renewal	92-31 Union Hall Street
Office of Rent Administration	Jamaica, New York 11433
Web Site: www.nyshcr.org

NOTICEOFAPARTMENTDEREGULATIONPURSUANTTOHIGHRENTVACANCY

MAILING ADDRESS OF TENANT:		MAILING ADDRESS OF OWNER/AGENT:
Name: ______________________________________		Name: _______________________________________
Number/Street :	Apt. No.:	Number/Street:_________________________________
City		City
State, Zip Code: _______________________________		State, Zip Code: ________________________________
		( )
		Telephone Number: _____________________________

1.Previous status of the apartment: Rent Stabilized _________ or Rent Controlled __________

2.ReasonforDeregulation:

HighRentVacancy-Therentforthesubjectapartmenthasbeenlawfullyraisedtoanamountequaltoorgreater than$2,500.

3.LastLegalRegulatedRentorMaximumRent $_______________.

ThelastlegalrentorthemaximumrentmaybeverifiedbythetenantbycontactingDHCR. Thetenantcancontact theDHCRRentInfolineat(718)739-6400andrequestthataregisteredapartmentrenthistorybemailedtohisor herapartmentorthetenantcancompletearequestforaccesstopublicrecords(FormFOIL-1)andsubmitit

totheattentionoftheRecordsAccessOfficerattheaddresslistedabove.

4.Calculationoftherentthatqualifiesforderegulation:

(CompleteSection4initsentiretyiftheapartmentwaspreviouslysubjecttorentstabilization. Complete onlysub-section4.5iftheapartmentwaspreviouslysubjecttorentcontrolandindividualapartment improvementsweremade.)

4.1	LastLegalRegulatedRent(sameas#3)	$ ______________
	(i)AdditionalRentGuidelineincreases,applicableonlyifthelaststabilizedtenancy
	was more than 4 years prior to the signing of this lease.	$______________

4.2StatutoryVacancyIncrease

	(i) Increase based on (1 year) or (2 year) lease (circle one)		(_____%)	$ ______________
	(ii) Increasebasedonlengthoftime(8yearsormore)
	since last vacancy allowance or if no vacancy allowance
	has been taken, the number of years that the apartment
	has been subject to stabilization. (0.6% x number of years)			$ ______________
	(iii) Increasebasedonlowrentalamount. Ifapplicable
	complete (a) or (b), but not both.
	(a) Previous legal regulated rent was less than $300 -	$100		$ ______________
	additional $100 increase, enter 100
	(b) If the previous legal regulated rent was $300 or more
	but less than $500	(1) ________
	the sum of (i) and (ii)	(2) ________
	(1) minus (2). If less than zero, enter zero	(3) ________
	Amountfromline(3)			$ ______________
4.3	VacancyAllowance,ifpermittedbyNYCRentGuidelinesBoard		(_______%)	$ ______________
4.4	GuidelinesSupplementaryAdjustment,ifpermittedbyNYCRentGuidelinesBoard			$ ______________

HRVD-N (4/14)

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4.5Individual Apartment Improvements(IAI)

A. BathroomRenovation(checkallapplicableitems)

Complete Renovation(ifthisboxischeckedyouarenotrequiredtocheckIndividualItems)

OR
Individual Items
(Check all applicable items)
Sink
Shower Body
Toilet
Tub
Plumbing
Cabinets
Vanity
Floorsand/orWallTiles
Other (describe) ______________	Total Costs for Parts and Labor	____________________

TotalRentIncrease(1/40th or1/60th) ____________________

(A)

B.KitchenRenovation(checkallapplicableitems)

Complete Renovation(ifthisboxischeckedyouarenotrequiredtocheckIndividualItems)

OR
Individual Items
(Check all applicable items)
Sink
Stove
Refrigerator
Dishwasher
Cabinets
Plumbing
Floor and/or Wall Tiles
Counter Tops
Other (describe) ______________	Total Costs for Parts and Labor	____________________

TotalRentIncrease(1/40th or1/60th) ____________________

(B)

C.Other(checkallapplicableitems)

		Total Rent Increase (1/40th or 1/60th) ____________________
		(C)
		$____________________
		Total IAI Rent Increase
		(Sum of (A)(B) and (C)
5.	NewRent -QualifyingforDeregulation	$ ___________________
	(must be $2,500 or more)
6.	ActualRentpaid	$ ___________________

I certify that the information provided in this notice is accurate and complete to the best of my knowledge and that I am complying with the requirements of the registrations cited in this notice and attached information and instructions.

Information and Instructions

•RelevantCodeSections

RentStabilizationCode2520.11(u) TenantProtectionRegulations2500.9(s)

•Thisnoticeisrequiredtobeserved,bytheowner,onthefirsttenantofthehousingaccomodationafterthe unitbecomesexempt/deregulatedfromtherentlaws. AlthoughthisformispromulgatedbyDHCR,the regulationsdonotrequireDHCRtoreviewtheaccuracyofthecontentsofthecompletedformandthe formisnotrequiredtobeservedonDHCR. However,DHCRonitsowninitiativemayconductauditsof thesenotices.

•Thisnoticeisrequiredtobesentbycertifiedmailtothetenant,within30daysafterthetenancy commencedorafterthesigningoftheleasebybothparties,whicheveroccursfirst,orshallbedelivered tothetenantatthesigningofthelease.

•Inaddition,theownershallsendandcertifytothetenantacopyofaregistrationstatementforsuch housingaccomodationfiledwithDHCRindicatingtheexempt/deregulatedstatusandthelastlegalregulated rent. Itshallbesentwithin30daysafterthetenancycommencesorthefilingofsaidregistration,whichever occurslater.

•Forpreviouslyrentcontrolledapartments,intheactualcalculationofafairmarketrent,intheeventofa challenge,consideration maybegiventorents“generallyprevailingforhousingaccommodationslocatedin thesameareaasthehousingaccommodationinvolved”or“totheapplicablefairmarketrentguidelines establishedannuallybytheNYCRentGuidelineBoard”forsuchchallengesinadditiontotheIAI informationprovidedhere.SeeNYCRR2522.3(e).

•Forpreviouslyrentcontrolledapartments,thetenantmaychallengethederegulationbyfilingaFair Market RentAppealwithDHCRwithin90daysofserviceofthisnoticeorserviceofacopyofthe above-referencedregistrationstatement,whicheveroccursfirst.

•Forpreviouslyrentstabilizedapartments,thetenantmaychallengethederegulationbyfilinganOvercharge complaintwithDHCRwithinfouryearsofthecommencementdateofthelease.

•DHCRmayconvertaFairMarketRentAppealoroverchargecomplainttotheappropriate complaintbasedonthepreviousregulatorystatusoftheapartment.

•TheActualRentPaidcanbemoreorlessthantheNewRentQualifyingForDeregulation,iftheapartment waspreviouslysubjecttorentstabilization. However,iftheapartmentwaspreviouslysubjecttorentcontrol theActualRentPaidmustbethesameastheNewRentQualifyingForDeregulation.

•Ifthelaststabilizedtenancywasmorethan4yearspriortothesigningofthisleaseseeRSC2526.1a(3)(iii) andTPR2506.1(a)(3)(iii)orDHCRFactSheet#5-VacancyLeases,whichmayentitletheOwnerto additionalrentguidelineincreasesoverthelaststabilizedtenancy.

HRVD-N (4/14)

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