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HOA Assessment Hardship Request Form

Communications

Form for homeowners experiencing financial hardship to request a payment plan or temporary assessment deferral.

About this template

Financial hardship requests put boards in a difficult position — they want to be compassionate, but they also have fiduciary obligations to all homeowners. A formal hardship request process creates a consistent, fair framework: the homeowner submits a written request with documentation, the board reviews it under a defined policy, and a decision is issued in writing. This process protects both the homeowner and the board, and demonstrates that the association handles sensitive financial matters with care and consistency.

What's included
  • Homeowner identification and account information
  • Nature of the hardship and supporting documentation required
  • Requested relief — payment plan, deferral, or fee waiver
  • Proposed payment plan schedule from the homeowner
  • Attestation of current account status and good faith intent
  • Board review process and decision timeline
When to use this template

Make this form available on your community portal and include a reference to it in delinquency notices. Encourage homeowners facing financial difficulty to contact the board before their account is referred for legal collection.

Template preview
Replace all [BRACKETED] fields with your community's details
[COMMUNITY NAME] HOMEOWNERS ASSOCIATION
ASSESSMENT HARDSHIP REQUEST FORM
CONFIDENTIAL

Date: [DATE]

----- HOMEOWNER INFORMATION -----
Name: ___________________________________
Property Address: ________________________
Mailing Address (if different): ____________
Phone: ____________________ Email: ________

----- ACCOUNT STATUS -----
Current Balance Due: $___________________
Months Past Due: ________________________
Last Payment Date: ______________________

----- NATURE OF HARDSHIP -----
Please briefly describe your financial hardship:
(Examples: job loss, medical emergency, death of co-owner, divorce)

_______________________________________________
_______________________________________________

Documentation attached (check all that apply):
[ ] Letter from employer (layoff / reduction in hours)
[ ] Medical bills or documentation
[ ] Unemployment benefit statement
[ ] Other: ________________________________

----- REQUESTED RELIEF -----
[ ] Payment Plan — I propose to pay $______ per month beginning [DATE]
[ ] Temporary Deferral — I request deferral of [X] months, beginning [DATE]
[ ] Fee Waiver — I request waiver of late fees / interest totaling $[AMOUNT]

Proposed payment plan:
Month 1: $________  Month 2: $________  Month 3: $________
(Attach additional schedule if needed)

----- CERTIFICATION -----
I certify that the information provided is accurate and complete. I understand this request will be reviewed by the Board in executive session and that I will be notified of the decision within [14] days.

Signature: _________________________ Date: ____________

Return to: [TREASURER NAME] at [EMAIL / MAILING ADDRESS]
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Tip

Make this form available on your community portal and include a reference to it in delinquency notices. Encourage homeowners facing financial difficulty to contact the board before their account is referred for legal collection.

LotWize generates this automatically with your community's actual details

Stop filling in brackets. LotWize knows your homeowners, your CC&Rs, and your violation history — it generates hoa assessment hardship request form documents in seconds, pre-addressed and ready to send.

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This template provides general guidance only — not legal advice. HOA rules and document requirements vary by state and by your governing documents. Always consult an HOA attorney before using any document in a legal or enforcement context.