INTENT TO VACATE

 Landlord Name & Address

__________________________

__________________________

__________________________

I (print name)____________________________, am giving notice to vacate the unit located at (current address)__________________________________________________.

I will be completely moved out by (enter date) ________________________.

Will the above family leave owing a balance? (  ) yes  or (  ) no

If so how much?_____________________

Have you set up a repayment agreement? (  ) yes or (  ) no

If so please attach a copy of this agreement.

****ATTN LANDLORDS-The Section 8 Office strongly urges you to complete a walk-through inspection of your unit with the tenant before signing this form.  If no is checked on the two questions above, Section 8 will assume that the tenant is leaving in good standing with you and process the tenants new move as scheduled.***

I fully understand that after I submit this form I have to be issued a voucher and an RTA package before I am able to move.

In the event that I will be remaining in the above-mentioned unit I must notify this office in writing within ten (10) business days before my move out date.  If I do not notify this office in writing I understand that I am responsible for the following months full rent.

I will clean the unit and repair any damages caused by my family before vacating.  I will contact the landlord on the day of my departure in order to return the keys.

Sincerely,

__________________________________               ____________________

Tenant Signature                                                           Date

___________________________________              ____________________

Landlord Signature                                                       Date