• 1003 Pebble Beach Dr. Bakersfield, Ca 93309
(661) 831-2035

OUR FORMS

Download the form, print out, fill out and turn into the office.

2026 Statement of Occupancy Form

1) After completing, return this form to: Kern City Civic Association (or KCCA), 1003 Pebble Beach Dr., Bakersfield, CA. 93309, or email to kerncity15@gmail.com
2) NOTE: You only need to provide the following ID one time: A CLEAR copy of a driver’s license OR birth certificate OR passport for EACH resident at your property. ID’s are not due each year except for new occupants.
3) Complete each line below. Do NOT write “Same as last year,” “No changes,” etc.
Note: Write below the name and infomatio for EVERY occupant who lives at the property. Name/DOB/Phone/Veteran/Branch/License Plate
Kern City is an age-restricted, Senior Citizen Housing Community, consistent with California Civil Code 51.3. The Housing for Older Persons Act of 1995 (HOPA) requires Kern City Civic Association (KCCA) to have on file the ages of Kern City residents to ensure compliance with federal and state requirements. The qualifying resident must be at least age 55 and others age 45 or older.
2026 ANNUAL NOTICE OF ADDRESS, Representative and Rental Status
ivil Code, Section 4041 requires each Owner of a separate interest (a Kern City property) to provide written notice to the Kern City Civic Association of all the following information annually. Please provide the information in the form below and return the completed form to the Association within 30 days. If the requested information is not provided, the property address of the Owner's Kern City property will be used for notices.

2026 Rental Property Owner Form

A separate copy of this form is required for each rental property.
NOTE: If your Kern City property is NOT rented, ignore this page.
Required Rental Information
The Kern City Civic Association (KCCA) must have on file for every rental property the following: Each occupant’s name, proof of age document, contact phone number(s), and emergency contact person(s) phone number.

Declaration of Rules, Section IV reads: Responsibilities of Owners: Each Owner of a lot is responsible for the acts of their tenants, guests and invitees. Each Owner is responsible for informing their tenants, guests and invitees of the rules by which the Association and development are operated.

Each owner shall include in any lease or rental agreement by which their property is occupied by another a provision which states substantially as follows: “Tenant understands that the property being rented is part of a deed restricted, age restricted, common interest development. Tenant understands and agrees to be bound by the governing documents which regulate activities within the complex.”

Failure to adequately supervise the activities of tenants, guests or invitees shall provide a basis for discipline against the owner involved.

No owner shall rent property to any person or persons who do not qualify under Section 3 herein, or any of the sections of Article I of the Kern City Civic Association Bylaws.

No owner shall sell property or otherwise transfer title of property to any person or persons who do not qualify under Section 3 herein, or any of the sections of Article I of the Kern City Civic Association Bylaws, unless the buyers who do not qualify under Article I will not reside in the dwelling.

Effective November 14, 1991, property owners are required to notify the Kern City Civic Association office in writing prior to any change in occupancy.

Effective November 14, 1991, verification of age of new owners or renters is to be presented to the Kern City Civic Association office prior to taking occupancy.

Note: The information above is only part of the owner requirements. For all rules, please read the full Bylaws and CC&Rs.
I certify that I have read, understand and agree to the above requirements.

KC Architectural Review
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Kern City Architectural Review

PROPERTY OWNER’S ALTERATION APPLICATION
The KCCA Declaration of Restrictions, Section 1,H,14,D. reads: Improvements and Alterations. No improvements of any type or any alterations to an improvement shall be made, constructed, installed or maintained upon any lot unless and until plans for such improvements or alterations thereof have been approved by the Architectural Control Committee.

The architectural committee will review all submissions, and upon receipt of documents sufficient to fully define the nature, scope, and impact of the proposed project, will render a decision within 10 days unless a decision is required by the Kern City Civic Association Board of Directors.
ROPERTY OWNER CONTACT INFORMATION
APPROXIMATE DATE TO BEGIN & END WORK
ADDITIONAL REQUIREMENTS:
1- Attach plans, drawings, lot plats, and anything else that will be used to obtain building permits, if required. If the project does require a building permit, please attach.
2- Add notes, sketches or anything that shows the location of the proposed alteration in respect to all other structures on the lot (e.g., draw where shed will be compared to house and property line).
3- Provide the size, shape, and type of material and whether electricity will be added.
4- Provide a picture or photo of the color or a dab or a swatch of the paint color.

Electronic Communication

Members, do you prefer to receive our communications electronically?

Note: If you dont want to receive anything by email or fax ignore this page.
The Kern City Civic Association (KCCA) currently sends important communications, such as the yearly budget and the Annual Policy Statement package, on paper by U.S. mail to each member’s address. But did you know that you have the right to receive communications electronically, such as via email or fax, instead of by U.S. mail (Civil Code §§ 4040, 4050 and Corporate Code §20)?
PLEASE READ AND SIGN BELOW ONLY IF YOU PREFER ELECTRONIC COMMUNICATIONS.
You have the right to continue receiving communications on paper via U.S. mail which is how KCCA has provided it in the past. This form only needs to be completed by you if you would like to receive future communications electronically instead of, or in addition to, U.S. mail. That is because, according to California law, you are entitled to receive information from KCCA via mail (paper), email, and/or fax. If you want some but not all communications to be sent electronically, please check which ones below that you prefer to be sent electronically.
Note: The election package must be mailed because it includes envelopes for members to mail ballots back.

Also, please note that requesting information by fax can mean that 50 or more pages might be transmitted.

KCCA cannot and will not sell or transmit a member’s personal information for any purpose without the consent of the member.
PLEASE READ AND SIGN BELOW
I have read this document and I understand that I can receive KCCA communications via regular U.S. mail and/or electronically. If I want documents sent by U.S. mail, I do not have to do anything. If I want some or all communications sent electronically, I must read and sign this form requesting electronic communications and return it to KCCA, 1003 Pebble Beach Dr., Bakersfield, CA 93309 or email it to kerncity1003@gmail.com.

Notice of Concern Form

The board of directors is aware that some things people do can be annoying to others. Some matters may be within the scope of Kern City, some items may be issues for the City of Bakersfield. While the Board cannot monitor the behavior of our residents and guests, we believe you have an obligation to report on things which may be against our CC&R’s, by-laws, or which may be offensive. The information you provide will help the Board make decisions about what might be done to resolve concerns.

Volunteer Hours Form

Due by the 5th of each month