Occupancy Concerns Form

State
County
Name
First Last
TO WIT: 1. I am competent to be a witness in a judicial proceeding, am over 18 years of age and have personal knowledge of the facts asserted herein. 2. I am the owner of the property located at
Address
Salisbury, Maryland, (hereinafter referred to as "Property"). 3. I am personally familiar with the Property and its occupancy. 4. The property is not in violation of Section 15.24.490 of the Salisbury Municipal Code because
Reason Why Property Is Not In Violation
- It is NOT occupied by more than two people
- The property is occupied by more than two persons who are related by blood, marriage, adoption, guardianship or other duly authorized custodial relationship.
- The property is occupied by up to four persons who are not related as described in Paragraph B, but who have been granted a special exception as a “functional family” as defined in Section 15.24.490 of the Salisbury Municipal Code.
- Health care or domestic servant
DO SOLEMNLY AFFIRM under the penalties of perjury and upon personal knowledge that the contents of the foregoing paper are true.
Digital Signature of Owner

Please enter your name as your signature