Notice to Vacate Form
Resident Information
Participant Name:
Room Number:
Date Notice Submitted:
-
Month
-
Day
Year
Date
Intended Move-Out Date:
-
Month
-
Day
Year
Date
Forwarding Address:
Forwarding Phone Number:
Format: (000) 000-0000.
Choose a Reason for Vacating
Moving to Independent Housing
Relocating to Another Program
Returning to Family
Employment Relocation
Health Reasons
Financial Reasons
Other:
Other
Participant Notice
I am voluntarily providing written notice of my intent to leave RAD Supportive Living, LLC.
I understand and acknowledge the following:
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I am required to provide a
30-day written notice
before voluntarily leaving the program.
My notice must be submitted in writing to Program Management. Verbal notice does not satisfy this requirement.
I remain responsible for all applicable program fees during the full 30-day notice period, even if I choose to move out before the notice period ends.
Failure to provide the required 30-day written notice may result in:
Forfeiture of any refundable deposits (if applicable).
Ineligibility for future enrollment in RAD Supportive Living, LLC.
Negative referral documentation for future housing or supportive living programs.
Move-Out Checklist
Return all keys, access cards, and other property belonging to RAD Supportive Living, LLC.
Remove all personal belongings from the room.
Leave the room in a clean condition.
Provide a forwarding address if requesting the return of any refundable deposit (if applicable).
Schedule a final room inspection with Program Management.
Participant Certification
I certify that I am voluntarily submitting this Notice to Vacate and understand the policies outlined above.
Participant Signature:
Date:
Program Manager Signature:
Date:
Office Use Only
Was 30-Day Notice Received:
Approved Move-Out Date:
Was Final Inspection Completed:
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Any Outstanding Balance: $
Deposit Returned (if applicable):
Additional Notes:
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Should be Empty: