(a) A tenant may notify the landlord that the tenant intends to terminate the tenancy if the tenant, a household member, or an immediate family member was the victim of an act that constitutes any of the following: (1) Domestic violence as defined in Section 6211 of the Family Code. (2) Sexual assault as defined in Section 261, 261.5, 286, 287, or 289 of the Penal Code. (3) Stalking as defined in Section 1708.7. (4) Human trafficking as defined in Section 236.1 of the Penal Code. (5) Abuse of an elder or a dependent adult as defined in Section 15610.07 of the Welfare and Institutions Code. (6) A crime that caused bodily injury or death. (7) A crime that included the exhibition, drawing, brandishing, or use of a firearm or other deadly weapon or instrument. (8) A crime that included the use of force against the victim or a threat of force against the victim. (b) A notice to terminate a tenancy under this section shall be in writing, with one of the following attached to the notice: (1) A copy of a temporary restraining order, emergency protective order, or protective order lawfully issued pursuant to Part 3 (commencing with Section 6240) or Part 4 (commencing with Section 6300) of Division 10 of the Family Code, Section 136.2 of the Penal Code, Section 527.6 of the Code of Civil Procedure, or Section 213.5 or 15657.03 of the Welfare and Institutions Code that protects the tenant, household member, or immediate family member from further domestic violence, sexual assault, stalking, human trafficking, abuse of an elder or a dependent adult, or any act or crime listed in subdivision (a). (2) A copy of a written report by a peace officer employed by a state or local law enforcement agency acting in the peace officerâs official capacity stating that the tenant, household member, or immediate family member has filed a report alleging that the tenant, the household member, or the immediate family member is a victim of an act or crime listed in subdivision (a). (3) (A) Documentation from a qualified third party based on information received by that third party while acting in the third partyâs professional capacity to indicate that the tenant, household member, or immediate family member is seeking assistance for physical or mental injuries or abuse resulting from an act or crime listed in subdivision (a). (B) The documentation shall contain, in substantially the same form, the following: Tenant Statement and Qualified Third Party Statement under Civil Code Section 1946.7 Part I. Statement By Tenant I, [insert name of tenant], state as follows: I, or a member of my household or immediate family, have been a victim of: [insert one or more of the following: domestic violence, sexual assault, stalking, human trafficking, elder abuse, dependent adult abuse, or a crime that caused bodily injury or death, a crime that included the exhibition, drawing, brandishing, or use of a firearm or other deadly weapon or instrument, or a crime that included the use of force against the victim or a threat of force against the victim.] The most recent incident(s) happened on or about: [insert date or dates.] The incident(s) was/were committed by the following person(s), with these physical description(s), if known and safe to provide: [if known and safe to provide, insert name(s) and physical description(s).] (signature of tenant) (date) Part II. Qualified Third Party Statement I, [insert name of qualified third party], state as follows: My business address and phone number are: [insert business address and phone number.] Check and complete one of the following: ____I meet the requirements for a sexual assault counselor provided in Section 1035.2 of the Evidence Code and I am either engaged in an office, hospital, institution, or center commonly known as a rape crisis center described in that section or employed by an organization providing the programs specified in Section 13835.2 of the Penal Code. ____I meet the requirements for a domestic violence
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