Vacant Possession Form — Centennial Living

Acceptance
I / We confirm that the above premises has been vacated and all possessions have been removed. I / We understand that any possessions that remain in the premises may incur a disposal fee to have them removed. I / We confirm that we no longer have the right to access the premises. I / We confirm that we have handed the marked items above to the Village Manager. I / We confirm that we have left the marked items above in the premises. I / We understand what utilities require cancellation (if any). I / We understand that monthly service charges/levies continue to accrue from the date vacant possession is provided in accordance with the residence contract. I / We hereby give lessee's notification to the lessor to reclaim possession of the premises.

Acceptance

I / We confirm that the above premises has been vacated and all possessions have been removed.
I / We understand that any possessions that remain in the premises may incur a disposal fee to have them removed.
I / We confirm that we no longer have the right to access the premises.
I / We confirm that we have handed the marked items above to the Village Manager.
I / We confirm that we have left the marked items above in the premises.
I / We understand what utilities require cancellation (if any).
I / We understand that monthly service charges/levies continue to accrue from the date vacant possession is provided in accordance with the residence contract.
I / We hereby give lessee's notification to the lessor to reclaim possession of the premises.

Type of Authorised Representative (e.g. POA, NOK, Executor, Solicitor, Advisor)
Signed Date
Signed Date

Receipt by Village Manager	Date
Signature

Completed form to be sent to the following:

Date
Village	WYNDHAM GRANGE VILLAGE
Property Number #
Resident Name/s
Authorised Representative Name