Short-Term Rental Cancellation Request

You are required to notify the Department of Licensing and Consumer Protection if you are no longer operating a short-term rental business. As the short-term rental property owner, you may use this form to notify the Department and to request that the Short-Term Rental Division cancel your license. Please note that upon submission of your cancellation request, your license will be cancelled and the authority granted therein is no longer valid. Once the Short-Term Rental license is cancelled, it cannot be reactivated. If you wish to operate a short-term rental property business at a later time, a new application and fees will be required.

***PLEASE NOTE THAT BY COMPLETING, SUBMITTING AND SIGNING THIS FORM, YOU CONFIRM YOUR AUTHORITY TO AFFECT THE CANCELLATION OF THIS SHORT-TERM RENTAL LICENSE.***

Short-Term Rental License Number (16-digit number in the upper righthand corner of your license).*

Reason for Cancellation*

No Longer Operating a Short-Term Rental

Property Sold

Other

Name of Property Owner (Name on License)*

Location of Short-Term Rental Property*

Full Name of Party Requesting Cancellation*

IMPORTANT: Only the short-term rental property owner/licensee is authorized to request the cancellation of a short-term rental license.

Title of Requestor*

Owner

Owner's SSN (###-##-####)*

Owner's Email Address*

Owner's Phone Number*

Phone

I certify that the above statements on this application are true and complete to the best knowledge and belief. I agree to comply with all applicable laws and regulations of the District of Columbia. I/We understand that, anyone who makes a false statement on this form can be criminally prosecuted; and, if convicted, fined up to $1000, imprisoned up to 180 days, or both, under D.C. Official Code (§) 22-2405.