2019-10-15 DECLARATION OF NON STVR STATUSVACATION
DECLARATION OF NON SHORT-TERM
VACATION RENTAL STATUS
Chapter 325 of the La Quinta Municipal Code requires a valid registration certificate for all short-term vacation rental units rented for 30
consecutive da%s or less. One l*onn is required forr each unit/pmpertp and om nner. PROPERTY OWNER'S NAME(S): IV UL OW &46A UA a U 1NI a . �•V
PROPERTY ADDRESS: -Old MDN �D L stpue-+
I DECLARE THAT:
❑ I NO LONGER OWN THE PROPERTY. MY OWNERSHIP ENDED ON
I DISPOSED OF THE PROPERTY TO:
NAME:
MAILING ADDRESS:
dI AM NOT RENTING THE PROPERTY FOR 30 CONSECUTIVE DAYS, OR LESS. I
UNDERSTAND THAT IF I DO RENT FOR 30 CONSECUTIVE DAYS OR LESS, I AM REQUIRED
TO REGISTER THIS PROPERTY PURSUANT TO CHAPTER 3.25 OF THE LA QUINTA
MUNICIPAL CODE.
❑ OTHER (PLEASE BE SPECIFIC):
I DECLARE, UNDER PENALTY OF PERJURY THAT TO THE BEST OF MY KNOWLEDGE, THE
STATEMENTS HEREIN ARE TRUE, CORRECT, AND COMPLETE. FAILURE TO OBTAIN A REQUIRED
SHORT-TERM VACATION RENTAL PERMIT AND PAY ALL REQUIRED TRANSIENT OCCUPANCY
TAXES, CAN RESULT IN A CITY ISSUED CITATION AND/OR FINES.
Property Owner's Signature: � tr j1 i �_UJR 111 A., ) Date: 1D I I
Return this form within 5 days to: City of La Quinta
Design and Development Department
Short -Term Rental Program
78-495 Calle Tampico
La Quinta, CA 92253
Phone: 760.777.7000
Email: vacation rental@la-quinta.org
78-495 Calle Tampico La Quinta, CA 92253 760.777.7000