Hello Cupertino Homeowner!

As a requirement of the City of Cupertino Below Market Rate (BMR) program, all homeowners are required to complete and submit the annual Self-Certification of Owner Occupancy form ("Form").The online Forms allow each household to submit their annual certification of occupancy and upload supporting documents, securely, online. Once you submit your Form and documents, they will transfer into our client management system.

Please be assured that they online Form is secure and information submitted is treated as strictly confidential.

All Forms must be received by March 1, 2024.

If you have any questions or concerns or if you are in need of interpretation, please email Cupertino@risehousing.com or call (415) 301-5448.

Thanks!

Rise Housing Team

Non-Discrimination Policy

Rise Housing Solutions and the City of Cupertino do not discriminate against any persons on the grounds of race, color, religion, national origin, ancestry, sex, gender, gender identity, gender expression, sexual orientation, marital status, familial status, source of income, genetic information, medical condition, physical disability or mental disability, or any other category protected by law.

Self-Certification of Occupancy & Submittal

By checking the box and writing my/our name(s) below, I/we herby certify to the City of Cupertino under penalty of perjury that I/we occupy the BMR home as my/our principal place of residence, acknowledge that the information provided and any documents or information I/we provide to the City is true and correct to the best of my/our knowledge, and that I/we have occupied the home for at least 10 months out of the past 12.

YesNo

If you answered no, and you did not occupy your home for at least 10 of the past 12 months, please explain (max length 300 characters).

First Name

Last Name

First Name

Last Name

When you hit the Submit button below, you should receive an email confirming your submission. If you do not receive an email, please reach out to cupertino@risehousing.com.

2024 Self-Certification of Owner Occupancy

Self-Certification of Occupancy & Submittal