MEMPHIS HOUSING AUTHORITY HOUSING CHOICE VOUCHER

MEMPHIS HOUSING AUTHORITY

HOUSING CHOICE VOUCHER PROGRAM

Intent to Move Notification

DearHCVPParticipant:

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BeforeyoucompletetheattachedIntenttoMoveNotificationform,pleasereadthefollowing:

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Youcanrequesttorelocate60–120daysbeforeyourleaseexpires.Ifyourlease doesnotexpire

within60‐120daysofyourrequest,yourrequesttomovewillbedenied.

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Youmustalsomeetthefollowingcriteriatovoluntarilymove:

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 Yourleaseexpireswithin60–120days.

 You must not have an outstanding balance for rent and/or damages above normal wear

and tear.Ifyou havean outstanding balance, youmust satisfy ormake arrangements to

satisfytheoutstandingbalance.

 Yourlandlordmustattestthatyouareleavingthepropertyin“goodstanding.”

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Iftheowner/agentatteststhatyourfamilyisnotin“goodstanding”andprovidessufficientproof

to establish it, you will not be able to move and your assistance may be terminated.Good

standingmeansthatyoudonotowemoney,youdonothaveanydamagestotheunit,andyour

lease expires within 60‐120 days.If you are not in “good standing”, please do not submit an

IntenttoMove.

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MHA will consider protections under VAWA and may approve a move regardless of lease 

expiration or good standing for victims of domestic violence, dating violence, stalking or sexual

assault.

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IftheMemphisHousingAuthoritydeterminesthatyouareeligibletomove,youwillbemaileda

Voucher and Request forTenancy Approval(RTA) packet.Youwill have sixty(60) days fromthe

dateofvoucherissuancetofindasuitableunit.

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Pleasecontactourofficeifyouhaveadditionalquestionsat(901)‐544‐1347.

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Thanks.

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Housing Choice Voucher Program

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

MEMPHIS HOUSING AUTHORITY

HOUSING CHOICE VOUCHER PROGRAM

Intent to Move Notification

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The family listed below has advised MHAof itsintentto move.MHA requires this Intentto MoveNotification

form to be completed by the HCVP family and the owner/agent to verify the family has provided notice of its

intenttomoveandcurrentstatuswithleasecompliance.Familiesnotin

compliancewithHCVprogramandlease

obligations may not be eligible to move.The Housing Assistance Payments (HAP) contract and payments

automaticallyterminatewhenthefamilymovesfromtheunit.

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HOHName:_________________________Client#:______________Address:_______________________________

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HCVPFamilyHeadofHousehold(HOH)completethissectiononly.

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IcertifythatIhaveprovidednotice,asrequiredbythelease,totheowner/agentthatIintendtoter minate

my lease and move, and to the Memphis Housing Authority Housing Choice Voucher Program.I ha ve

satisfiedormadearrangementstosatisfyanyoutstandingobligationsunderthecurrentlease.Iintend

to

move‐outandreturnpossessionoftheabove‐unitby_______________________________,20______.

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_____________________________________________________________ _______________

HeadofHouseholdSignature    PhoneNumber Date

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PropertyOwnerorAuthorizedAgentcompletethissectiononly.

Hasyourtenantprovidedpropernoticeoftheirintenttovacate,asrequiredbythelease?

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YesNo Ireceivednoticeon____________.Theeffectivedateofthemove‐outis____________.

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Doesthetenantoweanyoutstandingbalancesforrentordamagestothepropertyabovenormalwearand

tear?

YesNo AmountowedforRent:___________________/Damages:__________________

AmountHeldbyOwner/AgentasSecurityDeposit:__________________

 IftheoutstandingbalanceowedislessthantheSecurityDeposit,themoverequestmaybeapproved.

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Isthetenantcurrentlyingoodstandingwiththelease?

YesNo Pleaseexplain:_____________________________________________________________.

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Pleaseattachanydocumentationtosupportyourclaim(s).

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Ihereby certifythat the information providedaboveis true and complete to thebestofmyknowledge. I

understand that Memphis Housing Authority will act upon the information provided by the owner/agent

andcancellingthisnoticewillrequiresufficientevidencetorescindtheissuanceofatenantvoucher.

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__________________________________________________________________ __________________

PropertyOwner/AgentSignature  PhoneNumber  Date

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ForMHAOfficeUseOnly

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ReceivedatMHAby________________________________________ ______________________

   MHARepresentativeName   Date

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Date(s)HAPContractTerminationNoticeMailed__________,20____/Dispute/DenialReceivedfromOwner_________,20____

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Isthefamilyeligibletomove?___Yes____No Ifno,statethereasonand/orattachdocumentation:

____________________________________________________