NYCHA 040.050 (Rev. 12/3/20)v8 TRANSFER – TENANT REQUEST FOR TRANSFER
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IF I AM GRANTED A TRANSFER, I ACCEPT THE
FOLLOWING CONDITIONS:
1. I must vacate my current apartment leaving it empty and unoccupied.
I understand that I will not receive a lease to the new apartment
unless my old apartment is left empty and unoccupied.
2. I must securely lock my current apartment door and return all keys to
your Property Management Office.
3. RENT OBLIGATION:
• New Apartment: Rent for the new apartment begins the date the
keys are ready.
• Current Apartment: I may be responsible for up to fifteen (15)
days rent on my current apartment after I have moved out.
4. I may also be responsible for miscellaneous charges on my current
apartment, undeterminable at this time, resulting from, but not limited
to, removal of wallpaper, removal of floor coverings, replacement
of fixtures, removal of debris, etc. I agree to pay all such charges
immediately or within a mutually agreed upon time period when
notified by Management.
5. Any money not paid when due can be collected in any court of
competent jurisdiction.
6. If I move to another NYCHA development, I agree as follows:
• Any unpaid money due NYCHA may be collected in any court
of competent jurisdiction including by a summary non-payment
proceeding in the Civil Court of the City of N.Y.
• Any termination of tenancy proceedings that could commence
against me in my current apartment may commence or continue
against me in my new apartment. Any conditions placed against
my tenancy while in the current apartment (for example: probation
or permanent exclusion) shall remain valid and apply to me in the
new apartment.
All conditions listed in this document will be deemed to constitute a
LEASE AMENDMENT and will be fully effective against me and the
entire tenancy in my new apartment.
K. TENANT TRANSFER CONDITIONS
A. TENANT’S SIGNATURE B. DATE:
1. FOR A TRANSFER WITHIN THE CURRENT NYCHA-OWNED OR NYCHA-MANAGED DEVELOPMENT:
2. FOR A TRANSFER TO A DIFFERENT NYCHA-OWNED OR NYCHA-MANAGED DEVELOPMENT:
J. TRANSFER OPTIONS
INTRA (Transfer in current NYCHA development)
INTER (Transfer to another NYCHA development) Borough of Choice:
Development of Choice:
I. Do you require an apartment for seniors only?
(To be eligible for a senior building, the head of household, or at least one co-lessee,
and all other household members must be at least 62 years of age.)
Y
N
A translation or larger-font version of this document is available from the Customer Contact Center and your
Property Management Office. NYCHA is providing the translation for your information only.
Please fill out the English language version of the document.
La traducción o una versión con letra de mayor tamaño de este documento está disponible en el Centro de Atención al Cliente
y en la Oficina de Administración de su residencial. NYCHA está suministrando la traducción en español sólo para su información.
Por favor, llene la versión en inglés del documento.
Перевод этого документа находится в Центре обслуживания клиентов. NYCHA предоставляет перевод только
для вашей информации. Пожалуйста, заполните английский вариант документа.
客戶服務中心備有文件的翻譯和大號字體版本可供索取。
NYCHA所提供的文件譯本僅供參考。請填寫文件的英文版本。
客户服务中心备有文件的翻译和大号字体版本可供索取。
NYCHA所提供的文件译本仅供参考。请填写文件的英文版本。
*
Y N
2. Do you require a larger apartment due to your medical needs?
* If Yes, please complete and submit NYCHA Form 040.426.
3. Do you require an apartment on a lower floor?
* If Yes, please complete and submit NYCHA Form 040.426.
4. Do you need to transfer for Other Medical Needs? Type of Accommodation Requested ____________________
*
You may consult with your Property Management Office concerning your transfer options described on this form.
Y N
Y
