Termination Acknowledgement Form printable pdf download

Termination Acknowledgement Form

OFFICE USE ONLY

FORM #:

877

HOUSEHOLD ID:

TICKLER #:

SECTION 8 OFFICE

EFFECTIVE DATE:

700 ANDOVER PARK W, SUITE A, TUKWILA, WA, 98188-3322

PHONE: (206) 214-1300 FAX: (206) 243-5927

TERMINATION ACKNOWLEDGEMENT FORM

, the owner and / or manager of the

(Print Name of Landlord)

Property located at

(Section 8 unit address)

at the above

release the tenant

(Print Name of Tenant)

mentioned property from his / her Section 8 Lease as of:

(Date of Release Must Be the End of the Month)

We understand that the Section 8 Housing Assistance Payment will terminate as of

the date of release. We encourage both parties to do a vacate inspection. All rent,

utility payments, and other charges should be up to date. If damage or unpaid

amounts are an issue, arrangements should be made to cover these costs. This will

be considered proper notice to vacate the premises.

Landlord's Signature

Date

Tenant's Signature

Date

TENANT PHONE #:_______________Tenant Email Address ____________________________

THE BEST PHONE NUMBER TO REACH YOU

You must contact you Senior Housing Specialist to schedule a moving appointment in order to obtain

your voucher.

Please allow at least 45 days to complete the moving process.

REV 03-01-2015 PAGE 1 OF 1

FORM # 877

Termination Acknowledgement Form