Form 12 – Rent Withholding Letter – Massachusetts Courts

Form 12, titled “Rent Withholding Letter,” is a standardized document used by tenants to notify their landlords of specific conditions in their apartment that violate the state sanitary code. The form 12 serves as a formal declaration that the tenant will withhold rent payments until the listed issues are resolved.

The form includes the following sections:

1. Date: The date when the letter is written.
2. Landlord’s Name and Address: Information about the landlord.
3. Description of Conditions: A detailed list of the conditions violating the state sanitary code (e.g., hole in the kitchen ceiling, leak in the kitchen drainpipe, running toilet, no lock on the back door, radiators leaking).
4. Previous Notifications: A statement indicating that the tenant has already informed the landlord of these issues and has given a reasonable time for repairs.
5. Certification of Sending the Letter: The tenant can certify that the letter was sent via regular mail, certified mail, or personally delivered, including the name of the person who delivered it and the date of delivery.
6. Tenant’s Signature: The tenant’s signature to validate the letter.
7. Tenant’s Contact Information: The tenant’s address and telephone number(s).

The form provides a clear and structured way for tenants to communicate significant maintenance issues to their landlords and assert their right to withhold rent until these issues are addressed.

Filling out this form involves a few straightforward steps. Follow this guide to complete the form correctly:

1. Date
   • Write the current date at the top of the form.
2. Landlord’s Information
   • Enter your landlord’s full name and address in the designated fields.
3. Description of Conditions
   • List the conditions in your apartment that violate the state sanitary code. Be specific about each issue. Examples might include:
     • Hole in the kitchen ceiling.
     • Leak in the kitchen drainpipe.
     • Toilet running continuously.
     • No lock on the back door.
     • Radiators leaking.

4. Notification Statement
   • The form includes a pre-written statement that you have previously notified your landlord about these conditions and given them a reasonable time to make repairs.
5. Certification of Sending the Letter
   • Choose the method by which you are sending this letter to your landlord:
     • Regular Mail: Check the box and fill in the date you sent the letter.
     • Certified Mail: Check the box and fill in the date you sent the letter.
     • Personally Delivered: Check the box and write the name of the person who delivered the letter, the date of delivery, and the name of the recipient.

6. Your Signature
   • Sign your name in the space provided to validate the letter.
7. Your Contact Information
   • Provide your full address and telephone number(s) so your landlord can reach you.

Fill out each section accurately and ensure that your landlord receives the letter through one of the certified methods. Retain a copy of the letter and any proof of delivery for your records.

https://www.masslegalhelp.org/sites/default/files/2024-01/lt1-form-12-rent-w-holding.pdf

Form 12 – Rent Withholding Letter

Form 12, titled “Rent Withholding Letter,” is a standardized document used by tenants to notify their landlords of specific conditions in their apartment that violate the state sanitary code. The form serves as a formal declaration that the tenant will withhold rent payments until the listed issues are resolved.

The form includes the following sections:

1. Date: The date when the letter is written.
2. Landlord’s Name and Address: Information about the landlord.
3. Description of Conditions: A detailed list of the conditions violating the state sanitary code (e.g., hole in the kitchen ceiling, leak in the kitchen drainpipe, running toilet, no lock on the back door, radiators leaking).
4. Previous Notifications: A statement indicating that the tenant has already informed the landlord of these issues and has given a reasonable time for repairs.
5. Certification of Sending the Letter: The tenant can certify that the letter was sent via regular mail, certified mail, or personally delivered, including the name of the person who delivered it and the date of delivery.
6. Tenant’s Signature: The tenant’s signature to validate the letter.
7. Tenant’s Contact Information: The tenant’s address and telephone number(s).

The form provides a clear and structured way for tenants to communicate significant maintenance issues to their landlords and assert their right to withhold rent until these issues are addressed.

Filling out this form involves a few straightforward steps. Follow this guide to complete the form correctly:

1. Date
   • Write the current date at the top of the form.
2. Landlord’s Information
   • Enter your landlord’s full name and address in the designated fields.
3. Description of Conditions
   • List the conditions in your apartment that violate the state sanitary code. Be specific about each issue. Examples might include:
     • Hole in the kitchen ceiling.
     • Leak in the kitchen drainpipe.
     • Toilet running continuously.
     • No lock on the back door.
     • Radiators leaking.

4. Notification Statement
   • The form includes a pre-written statement that you have previously notified your landlord about these conditions and given them a reasonable time to make repairs.
5. Certification of Sending the Letter
   • Choose the method by which you are sending this letter to your landlord:
     • Regular Mail: Check the box and fill in the date you sent the letter.
     • Certified Mail: Check the box and fill in the date you sent the letter.
     • Personally Delivered: Check the box and write the name of the person who delivered the letter, the date of delivery, and the name of the recipient.

6. Your Signature
   • Sign your name in the space provided to validate the letter.
7. Your Contact Information
   • Provide your full address and telephone number(s) so your landlord can reach you.

Fill out each section accurately and ensure that your landlord receives the letter through one of the certified methods. Retain a copy of the letter and any proof of delivery for your records.