Request for Overnight Guest


Resident: ________________________________________________________________

Address: ________________________________________________________________ 

Guest Name: ___________________________________________ No. of Persons: _____

Address: ________________________________________________________________

Vehicle Info: _____________________________________________________________
                                   (Year)              (Make)                       (Model)                          (Color)                       (Registration #)


Dates of Visit: From ______________ to ______________ Number of Days: ________

According to DHCD Regulations [760 CMR 6.06(3)(c)], “the stay of any overnight guest shall be limited to no more than a total of 21 nights (21 days if the guest regularly sleeps during the day) during any 12 month period”.   By my signature below, I agree that I understand this Regulation and Attleboro Housing Authority Policy regarding overnight guests and further agree to comply with
the aforementioned Regulation and Policy.


Resident’s Signature: _______________________________________


 For Office Use Only


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Approved                               Management Signature: __________________________________________

Disapproved                           Total Number of Days Used Over Last 12 Months: _______


Comments: _____________________________________________________________________________