Residence Life Office Damage Billing Appeal Form
Campus Address - Hall
Student Appartment Complex
Campus Address - Room Number
Term and Year Applying for Termination:
In the space provided below, please document the reason(s) for appealing your damage bill. If you are part of a group billing and are claiming your non-involvement, you must either: 1) have the responsible person contact the Residence Life Office directly to take responsibility for the damage or 2) provide documentation that you were not present during the time of the damage.
Appeals must be submitted within 30 days of the billing date. Appeal forms must be submitted via the on-line form to the Residence Life Office. Any appeals received after the 30 day timeline with not be reviewed and the student remains responsible for all charges.
Why are you disputing the bill?
Attach any additional documents here
Do Not Fill This Out