Request a Meeting Tenant/Applicant Name(Required)PhoneAddress(Required)Address 2Email (optional)In accordance with the grievance policy for Bangor Housing, I am requesting an informal meeting or formal hearing for the following reason (check one):(Required) Denial of Pre-Application Nonpayment of Rent Lease Violation (eviction) Termination of Subsidy (Section 8 participant only) Denial of Portability (Section 8 participant only) Denial of Reasonable Accommodation request Denial of request to add a family member Denial of request to add a full-time live-in aide Pet/Animal policy violation Remaining member of family Denial of transfer request PHA is requiring me to transfer Disagreement with maintenance charges Other Describe BrieflyAn informal meeting was held with a Bangor Housing representative.I want to appeal / dispute the decision made as a result of that meeting. Yes Date of Meeting MM slash DD slash YYYY You must specify at least two dates and time ranges, on business days only, within the next 14 calendar days, when you can attend an informal meeting or formal hearing:Date(Required) Month Day Year Time Range(Required)Choose time range9am – 11am1:30pm – 3:30pmDate(Required) Month Day Year Time Range(Required)Choose time range9am – 11am1:30pm – 3:30pmDate Month Day Year Time RangeChoose time range9am – 11am1:30pm – 3:30pm I understand an appointment letter will be mailed to me with the date and time of my meeting or hearing appointmentTenant Signature(Required)
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