Fair Criminal Record Screening for Housing Intake Form

Fair Criminal Record Screening
Housing Intake Questionnaire

The Fair Criminal Record Screening for Housing Act of 2016 prohibits District housing providers from asking about arrests, pending criminal accusations, or criminal convictions on an rental housing application or during the application review process (exceptions apply)*. If criminal background information is inquired or asked about during the application review process or if you believe your conditional offer of rental housing was improperly revoked because of your criminal background, please complete this form. More information about the law is available by visiting or calling the Office of Human Rights, or by visiting ohr.dc.gov/page/returningcitizens. Fields with asterisks (*) are required.

Complainant Information
Housing Provider Information
Incident Information

The following steps help us to ensure we have the proper information about your housing application experience and assists us in preparing for our intake interview with you. Please complete each step below to the best of your ability before submitting this complaint to us (required boxes are marked with

Step 1: Application Submission
Step 2: Conditional Housing Offer
Step 3: Offer Withdrawn
Step 4: Requesting Records
Step 5: Criminal Background
Attorney or Counsel Information (optional)
Additional Information
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