1000 Pre-Buyout Disclosure Form

San Francisco Residential Rent Stabilization and Arbitration Board
Esta notificacin puede afectar a sus derechos como

inquilino. Si necesita este formulario en Espaol, por
favor llame al 415-252-4602 o visite a la oficina de La
Junta del Control de Rentas en 25 Van Ness Avenue,
#320, San Francisco.
415-252-4602
25 Van Ness Avenue, #320, San Francisco
Pre-Buyout Negotiations Disclosure Form Required by Ordinance Section 37.9E

Beginning March 7, 2015, any landlord who wishes to commence buyout negotiations with a
tenant must first make certain written disclosures to the tenant. This three-page document
contains all of the legally required disclosures and must be served on the tenant prior to the
commencement of buyout negotiations. The following definitions apply:
Buyout negotiations means any discussion or bargaining, whether oral or written, between
a landlord and tenant regarding the possibility of entering into a buyout agreement.
A buyout agreement means an agreement wherein the landlord pays the tenant money or
other consideration to vacate the rental unit. (An agreement to settle a pending unlawful
detainer [eviction] action in court is not considered a buyout agreement.)
The landlord must fill in the blanks below prior to giving this Pre-Buyout Negotiations
Disclosure Form to the tenant:
(a) The landlord intends to enter into Buyout Negotiations to recover possession of the rental
unit located at:
San Francisco, CA
Tenants Address: Street Number
Street Name
Unit Number
Zip Code
(b) The following people will be conducting Buyout Negotiations on behalf of the landlord. (If
the landlord is an entity, the landlord shall provide the names of all people within that entity who
will be conducting the Buyout Negotiations.)
1.
2.
Print Name Here
3.
Print Name Here
4.
Print Name Here
Print Name Here
(c) The following people will have decision-making authority over the terms of the Buyout
Agreement on behalf of the landlord. (If the landlord is an entity, the landlord shall provide the
names of all people within that entity who will have decision-making authority over the terms of
the Buyout Agreement.)
1.
2.
Print Name Here
3.
Print Name Here
4.
Print Name Here
Print Name Here
1000 Pre-Buyout Negotiations Disclosure Form 3/7/15
(Page 1 of 3)
Printed on 100% post-consumer recycled paper
25 Van Ness Avenue #320

San Francisco, CA 94102-6033
www.sfrb.org
Phone 415.252.4602
FAX 415.252.4699

Tenant Disclosures Required by Rent Ordinance Section 37.9E
(1)
A tenant has the right not to enter into a Buyout Agreement or Buyout Negotiations.
(2) A tenant may choose to consult with an attorney before entering into a Buyout Agreement
or Buyout Negotiations.
(3) Tenants rights organizations and their contact information are listed on page 3 as
Attachment A.
(4) Information about tenants rights is also available at the Rent Boards office (25 Van Ness
Avenue, Room 320, San Francisco, CA), through its counseling telephone number (415-2524602) and on its website (www.sfrb.org). A tenant may visit the Rent Boards office for
information about other Buyout Agreements in the tenants neighborhood.
(5) A tenant may rescind a Buyout Agreement for up to 45 days after the Buyout Agreement is
fully executed. In order to rescind a Buyout Agreement, the tenant must, on or before the 45th
day following the execution of the Buyout Agreement by all parties, hand deliver, email, or place
in the mail a statement to the landlord indicating that the tenant has rescinded the Buyout
Agreement. Any Buyout Agreement that does not comply with the requirements of Rent
Ordinance Section 37.9E(f) shall not be effective and may be rescinded by the tenant at any
time.
(6) A landlords ability to convert the tenants building into condominiums may be affected by a
Buyout Agreement pursuant to Subdivision Code Section 1396(e)(4) if: (a) a senior, disabled,
or catastrophically ill tenant in the building entered into a Buyout Agreement for any unit in the
building, or (b) two or more tenants entered into Buyout Agreements during the period beginning
ten years prior to the date of the condominium conversion application and ending on the date of
the final or parcel map approval. For purposes of this subsection, a senior shall be a person
who is 60 years or older and has been residing in the unit for ten years or more at the time of
the Buyout Agreement; a disabled tenant shall be a person who is disabled within the meaning
of Title 42 United States Code Section 12102 and has been residing in the unit for ten years or
more at the time of Buyout Agreement; and a catastrophically ill tenant shall be a person who
is disabled within the meaning of Title 42 United States Code Section 12102 and who is
suffering from a life threatening illness as certified by his or her primary care physician and has
been residing in the unit for five years or more at the time of Buyout Agreement.
Each tenant must sign this three-page Pre-Buyout Negotiations Disclosure Form below
and write the date the landlord provided the tenant with the disclosure form. The landlord
is not required to file a copy of the Disclosure Form with the Rent Board. The landlord is
required to retain a copy of each signed Disclosure Form for five years, along with a
record of the date the landlord provided the disclosure to each tenant.
1.
2.
Print Tenants Name Here
Print Tenants Name Here
1.
2.
Tenants Signature
Tenants Signature
1.
2.
Date the landlord provided tenant with the Disclosure Form
Date the landlord provided tenant with the Disclosure Form
(Page 2 of 3)

www.sfrb.org
Phone 415.252.4602
FAX 415.252.4699

ATTACHMENT A TENANTS RIGHTS ORGANIZATIONS
AIDS Legal Referral Panel
1663 Mission Street #500
San Francisco, CA 94103
(415) 701-1100 (phone)
(415) 701-1400 (fax)
www.alrp.org
Asian Americans Advancing Justice - Asian Law Caucus
55 Columbus Avenue
(415) 896-1701 (phone)
(415) 896-1702 (fax)
www.advancingjustice-alc.org
Asian Pacific Islander Legal Outreach
1121 Mission Street
(415) 567-6255 (phone)
(415) 567-6248 (fax)
www.apilegaloutreach.org
Housing Rights Committee of SF

(bring proof of income; counseling is free)
th
th
417 South Van Ness Avenue (bet. 15 & 16 St.)
San Francisco CA 94103
(415) 703-8644 (phone)
(415) 703-8639 (fax)
Mon-Thurs: 1:00 p.m.-5:00 p.m.
www.hrcsf.org
Legal Assistance to the Elderly, Inc. (Age 60+)
701 Sutter Street (at Taylor Street)
(415) 538-3333(phone)
(415) 538-3316 (fax)
www.laesf.org
San Francisco Tenants Union
st
558 Capp Street (near Mission & 21 Street)
(415) 282-6622 (recorded message & hours)
www.sftu.org
Bay Area Legal Aid

(Section 8 and public housing)
th
1035 Market Street, 6 Floor
(415) 982-1300 (phone)
(415) 982-4243 (fax)
www.baylegal.org
SRO Collaboratives:
(1) Central City SRO Collaborative
48 Turk Street
(415) 775-7110 (phone)
www.ccsro.org
Bayview/Hunters Point Community Legal

(Tenants living within zip code 94124 only)
rd
4622 3 Street (in Salvation Army Outreach Center)
(415) 735-4124 (phone)
(415) 534-3469 (fax)
bhpcommunitylegal.org
(2) Chinatown SRO Collaborative

c/o Chinatown Community Development Center
1525 Grant Avenue
(415) 984-1489 (phone)
(415) 362-7992 (fax)
www.chinatowncdc.org
Causa Justa::Just Cause

(Spanish-speakers and SRO tenants)
2301 Mission Street, Suite 201
(415) 487-9203 (phone)
(415) 487-9022 (fax)
By Appointment Only:
Mon & Wed 1-5 pm;
Tues, Thurs & Fri 9:30-Noon & 1-5:30 pm.
www.cjjc.org
(3) Mission SRO Collaborative

938 Valencia Street
(415) 282-6209, ext. 12 or 16 (phone)
Tenderloin Housing Clinic
(Tenants in hotels and Tenderloin residents)
nd
126 Hyde Street, 2 Floor
(415) 771-9850 (phone)
www.thclinic.org
Chinatown Community Development Center

(Cantonese, Mandarin & English-speaking tenants)
663 Clay Street
(415) 984-2728 (phone)
(415) 984-2724 (fax)
www.chinatowncdc.org
(Page 3 of 3)

www.sfrb.org
Phone 415.252.4602
FAX 415.252.4699

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San Francisco Residential Rent Stabilization and Arbitration Board

Esta notificacin puede afectar a sus derechos como

25 Van Ness Avenue, #320, San Francisco

Pre-Buyout Negotiations Disclosure Form Required by Ordinance Section 37.9E

Print Name Here

Print Name Here

Print Name Here

Print Name Here

1000 Pre-Buyout Negotiations Disclosure Form 3/7/15

Printed on 100% post-consumer recycled paper

25 Van Ness Avenue #320

San Francisco Residential Rent Stabilization and Arbitration Board

Print Tenants Name Here

Print Tenants Name Here

Date the landlord provided tenant with the Disclosure Form

Date the landlord provided tenant with the Disclosure Form

1000 Pre-Buyout Negotiations Disclosure Form 3/7/15

Printed on 100% post-consumer recycled paper

25 Van Ness Avenue #320

San Francisco Residential Rent Stabilization and Arbitration Board

Housing Rights Committee of SF

Bay Area Legal Aid

Bayview/Hunters Point Community Legal

(2) Chinatown SRO Collaborative

Causa Justa::Just Cause

(3) Mission SRO Collaborative

Chinatown Community Development Center

1000 Pre-Buyout Negotiations Disclosure Form 3/7/15

Printed on 100% post-consumer recycled paper

25 Van Ness Avenue #320

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