Notice of intention to leave

Housing company / Address

Resident 1

Apartment

Departure date

First name

Last name

Date of birth

Others residents moving:

Others residents moving

Resident 2 date of birth, last name, first name

Resident 3 date of birth, last name, first name

Resident 4 date of birth, last name, first name

Where do you move in?

Where do you move in?

Address

ZIP / Postal code

City

People who are going to stay in the apartment

Everyone from our apartment is moving