Notice Of Intent To Vacate Form


Name: ____________________________ A#:____________________________Date_____________________________
Building: ________ Suite: ________ Bedroom: ____ Cell Phone__________________ E-mail____________________________
Forwarding Address___________________________ City: ___________________ State: ________ Zip: __________
I intend to vacate my assignment within University Housing on_________________________
For the following reason:
I am graduating from UAHuntsville at the end of the current semester.
I am withdrawing from UAHuntsville at the end of the current semester.
______________ _
I am withdrawing from UAHuntsville during this semester.
I will not be enrolled for classes at UAHuntsville next semester.
I am seeking approval due to an extenuating circumstance (specify below)
Student was found not to be enrolled (Administration Only Option)
Student Initial: _____ Student understands if he/she enrolls in any class for the upcoming semester(s) they will be assessed rental and
meal charges (if applicable).
Student Initial: _____I understand that for consideration of an extenuating circumstance, I must provide clear documentation
supporting the reason(s) stated below. I further understand that I must meet with, and have this form signed by the Resident Director
of my assigned area prior to consideration by the Assistant Director for University Housing.
If other, please explain in detail the reason you cannot remain in University Housing for the duration of your contract:
Important Reminders: Please Read Carefully
Minimum required notice is 15 days for residents in single student suites and 30 days for residents in one-bedroom
apartments and on-campus houses. Late cancellation will result in a $100 improper check-out charge.
Final move-out day is always the day following the last scheduled exam each semester. An additional rent charge will be
assessed for key possession and/or occupancy beyond the designated move-out day.
A $100 charge will be assessed for improper checkout (Contact your Resident Director with questions).
Checkout assessments and refunds are usually processed within six weeks after the end of the semester.
Resident Director Information/Recommendations:
Signature of Resident
Signature of RD
Assistant Director for University Housing:
Assistant Director for University Housing
A/C Op. Initials
(Reason for Denial)
If approved by the Assistant Director for University Housing please follow these directions for checkout. Failure to do so will result in a $100
improper checkout charge in addition to any cleaning and damage charges.
Remove all of your belongings from your bedroom and common areas.
Remove all stickers, adhesives, and markings from doors, windows, and walls.
Place all furniture in proper position (the position it was found upon moving in).
Clean all appliances, fixtures, cabinets, walls, windows, blinds, flooring, and furnishings.
Bag all trash and place in the trash room or dumpster.
Turn in all keys, cleaning, schedule a checkout appointment with your Resident Director.
Provide a forwarding address to University Housing, Charger Central, and your correspondents. SECH residents should also submit a
change of address form to the US Postal Service.


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