Arkansas Assistance-Animal Housing Accommodation Request
ARKANSAS ASSISTANCE-ANIMAL HOUSING ACCOMMODATION REQUEST
Date: [__/__/____]
To housing provider or association: [NAME AND DELIVERY ADDRESS]
From applicant or resident: [FULL NAME]
Dwelling or application: [STREET ADDRESS, UNIT, CITY, ARKANSAS ZIP]
Private response contact: [ADDRESS OR EMAIL]
Request
I request a reasonable accommodation under 42 U.S.C. § 3604(f)(3)(B) to keep the assistance animal described below at this dwelling. The animal helps with a disability-related need and helps me use and enjoy the home. Please make the exception identified below and respond in writing.
Animal name, species, and description: [________________________________]
Rule, restriction, or charge for which an exception is requested: [________________________________]
Requested accommodation:
☐ Allow the animal despite a no-animal rule or restriction.
☐ Do not apply a pet charge to this assistance animal.
☐ Other requested change: [________________________________].
How the animal helps with the disability-related need, without a diagnosis: [________________________________]
Information to evaluate the request
☐ My disability and the animal's related assistance are apparent. Please evaluate the request using the information available.
☐ I enclose information confirming my disability-related need for this animal. Enclosure: [DESCRIPTION].
☐ Please tell me privately what additional information is needed to evaluate the request. My preferred contact is [PRIVATE CONTACT METHOD].
If a clinician's letter for an emotional support dog is enclosed: Arkansas Code § 20-14-1003 places requirements on the clinician preparing that documentation. The clinician should identify the effective date, number, jurisdiction, and type of active professional license, and should check the section's client-relationship and evaluation requirements. This paragraph applies to clinician documentation for a dog; it does not say that every request must include such a letter.
Preferred response method: ☐ email ☐ mail ☐ telephone to arrange a written response
Applicant or resident signature: ______________________________ Date: [__/__/____]
Delivery record
Delivered to [NAME OR OFFICE] by ☐ email ☐ mail ☐ hand delivery ☐ housing portal on [__/__/____].
Delivery confirmation: [________________________________]
Official sources
About this template
- Last updated
- November 2, 2026
- Citations checked
- November 2, 2026
- Jurisdiction
- Arkansas
- Category
- Landlord & Tenant
Legal authority
- 42 U.S.C. § 3604(f)(3)(B) (reasonable accommodation in housing)
- Ark. Code § 20-14-1003(a) (clinician documentation for an emotional support dog)
Landlord-tenant paperwork governs who can stay in a property, on what terms, and what happens when something goes wrong. Leases, notices to quit, security deposit demands, and habitability complaints all have state and often city-specific requirements for timing, content, and service. Getting the paperwork right is what makes an eviction actually succeed or a security deposit actually come back, because judges regularly dismiss cases over small procedural mistakes.
Not legal advice
This template is provided for informational purposes. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Checked against the law it cites
A reviewer verified this template's legal citations against the official source on November 2, 2026.
42 U.S.C. § 3604(f)(3)(B) (checked November 2, 2026): "a refusal to make reasonable accommodations in rules, policies, practices, or services, when such accommodations may be necessary to afford such person equal opportunity to use and enjoy a dwelling"
Ark. Code § 20-14-1003(a)(1), enacted by 2023 Act 268 (checked November 2, 2026): "Possesses a valid, active license and includes the effective date, license number, jurisdiction, and type of professional license he or she possesses in the documentation required under this subsection"
Ark. Code § 20-14-1003(a)(3)(A), enacted by 2023 Act 268 (checked November 2, 2026): "establishes a client-provider relationship with the individual at least thirty (30) days prior to providing the documentation requested regarding the individual’s need for an emotional support dog"
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