UCSF Housing Agreement
Other Occupant Addendum
I, __________________________________________________ living at ________________________________________________
(Tenant name)
(UCSF Address)
request to update the other occupant information listed on my agreement.
Primary Tenant email:____________________________________ Apartment Type (Please check one): ☐1BR
☐2BR
☐3BR
PLEASE REMOVE:
Other Occupant Name:
Date of Birth:
Other Occupant Move-out date:
PLEASE ADD:
Other Occupant/Child Name:
Date of Birth:
Relationship to tenant:
Other Adult Occupant UCSF Affiliation – please check one:
☐UCSF Student
☐UCSF Postdoc
☐UCSF Faculty
☐Gladstone Postdoc
☐HHMI Postdoc
☐UCSF Staff
☐UCSF Resident/Clinical Fellow
☐Gallo Postdoc
☐ None
Other occupant email:
Other occupant phone:
For other occupant: Would you like your name to appear in the front door directory (Yes or No):
For other occupant: How would you like your name to be listed in the directory?
Other Occupant Move-in Date:
Please note that only the Tenant signs the housing agreement. Other occupants are not eligible to transfer the agreement to their name
because housing agreements are not transferrable. When the Tenant (agreement holder) vacates their apartment, the other occupant(s)
will be required to vacate as well.
This amends section 1.1 ADDITIONAL OCCUPANTS ("Additional Occupant" or “Additional Occupants”) of the UCSF Housing
Agreement. This addendum takes effect once this form is signed by both the Tenant and Housing Services.
Tenant signature: ____________________________________________________________________________________
Date: _____________________________________________________________________________________________
Housing Services signature: ____________________________________________________________________________
Date: _____________________________________________________________________________________________
OFFICE USE ONLY:
☐Update RMS
☐Update front door directory
☐Update package authorization pickup
☐e-File in RMS
☐Send copy to tenant
1505 4th Street, Box 3100
San Francisco, CA 94143
www.campuslifeservices.ucsf.edu/housing/
Phone: 415-514-4550
Fax:
415-514-4560
Email: [email protected]