COMMONWEALTH OF MASSACHUSETTS

________________,SS:

     HOUSING COURT DEPARTMENT
_______________ DIVISION

_________________________
PLAINTIFF(S)

VS.

________________________
DEFENDANT(S)

REFERRAL TO HOUSING SPECIALIST DEPARTMENT

NOTICE

        You  are  not  required,  prior  to  trial  to  go  before  the  Housing
Specialist.  You  have  the  right  to  refuse  referral  to  a  Housing
Specialist.

However,  the  Housing  Specialist  Department  can  sometimes  help  a
complainant and defendant arrive at an agreement satisfactory to both.

Housing Specialists are Court personnel. Anything said to a Housing
Specialist, and any agreement made before a Housing Specialist prior to
trial is held in strict confidence, and is not admissible as evidence if
a trial is held.

AGREEMENT

I have read the above notice and agree to referral to the Housing

Specialist Department.

Date: ___________

Address ______________________________

Complainant __________________________

City/State ___________________________

Telephone ____________________________

Defendant________________________

Address ______________________________

City/State ___________________________

Form Rev 7/99

Telephone ____________________________



Referral to Housing Specialist Department

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Massachusetts state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

---

About This Form:

• Sourced from www.mass.gov (2023-03)
• Page(s): 1
• Fields(s): 11
• Average fields per page: 11
• Reading Level: Grade 8
• LIST Grouping(s): GO-00-00-00-00.

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

---

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

---

Create an Interactive Version of this Form:

The Weaver creates a draft guided interview from a template form, like the one provided here. To learn more, read "Weaving" your form into a draft interview.