Vacate Notice Form

Resident Information

Last Name* First Name*

Weill Cornell Email*

Vacate Date

Primary Phone*

Vacate Date*

The method of your security deposit refund is dependent on where you reside after you move out of Weill Cornell Medicine housing. Please complete the relevant section below. Please allow 8 weeks after your vacate date to receive your refund.

Faculty and Postdoctoral Associates Only: Security Deposit Refund

Building*

I plan to fully vacate the unit as noted in my building's vacate procedures. I have read and fully complied with all of the terms of the Weill Cornell Housing License Agreement concerning checkout requirements and payment. If I am a faculty member or postdoctoral associate, I authorize the return of my security deposit as indicated above.

Signature of Primary Resident* Date*

Resident Certification

Apt. Number*

Personal Email*

ZipStateCity

Street Address

Housing Office staff will contact you if schedule conflicts require a change in vacate date.

Apt. Number

Please submit this completed form to the Housing Office at least 30 days prior to your requested vacate date. Please note that this form is designed to be completed electronically using Adobe Acrobat, which can be downloaded from the ITS website. Fields marked with an asterisk (*) are required. Please make sure to review specific move-out procedures for your building on the Housing website.

Resident Type* Student Postdoc Faculty

Some WCM buildings do not allow move-outs on certain days (e.g. Sundays, holidays). Please check your building's vacate procedures before selecting your vacate date. Also, if you pay your housing fee via payroll deduction, make sure to consider the WCM payroll calendar when determining your move-out date. Your payroll deductions will only be canceled once you fully vacate your apartment and check out. If you move out after the Sunday of a payroll week, you will be charged your housing fee in that week’s paycheck and then credited in the following paycheck.

If you will reside outside of the United States, you will receive your refund via electronic funds transfer (EFT). Please provide your banking information below. The name on the account must match your (the primary resident's) name. Note that we only provide EFT for international transactions.

Name of Bank Account Name

IBAN Number

Swift Code

If you will reside in the United States, you will receive your refund via mailed check. Please provide your new mailing address.

Account Number