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Personalized Eviction Moratorium Order Declaration Form Tool

Prepare a packet to notify your landlord of your right's under the Centers for Disease Control and Prevention’s eviction moratorium order, using an accessible, English and Spanish tool.

The interview-style tools, will prepare a cover letter and a signed personalized CDC Declaration Form, with the options to download PDF, print, and email it to your landlord. The email contains a cover letter and your personalized signed form.

This novel, accessible tool, is housed at MassAccess, but it produces a national form that can be used anywhere in the United States; consequently, the form is not intended for direct filing with the Massachusetts Trial Court or any Colorado Court. Mail or email the letter and form to your landlord.

Download • 99KB

Download PDF • 627KB

Form Samples

CDC Declaration editable
Download PDF • 234KB

To mitigate community spread of the novel coronavirus, the Center for Disease Control (CDC) has issued an order pausing residential evictions for some tenants unable to make rental payments due to hardships caused by the coronavirus. Use this form to see if you are covered by this order and to prepare a declaration to share with your landlord if you are.

For more information about the order, visit The New York Times FAQ



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