Exit Survey/ Tenancy Relinquishment Form

Helping To Improve Our Services The information we are asking for below is to help us to improve the service we provide to tenants and to help us understand the reason why people leave our property. The information provided is confidential and will only be used for research purposes. Office Use Only: Tenant Reference Number Q1. Where are you moving? To live with relatives To live with a partner To a residential care home Another Housing Association To a council property To a private rented property To buy your own home Other, Please tell us

Q2.

If you are moving to a council or housing association property what is the name of the organisation?

Q3. Q4.

Are you moving out of Birmingham? Please tell us why you are moving (any that apply) Buying my/our own home Nearer to family/friends Need larger/smaller home State of repair of my home Unhappy with area Need more support Near to work/college Relationship breakdown Financial reasons Unhappy with Optima Medical reason Problems with nuisance

Yes

No

Please feel free to make any further comments:

Q5.

Do you currently have a transfer application in with Optima? Yes No Dont know

If yes, please state how long you were on the transfer list for.
0 - 6 months 2 5 years Q6. 6 12 months 5- 10 years 1 2 years 10 years plus

How could Optima have persuaded you to remain in one of their properties? (Please tick the main reason only) Completed my repairs . Dealt with the anti-social behaviour in the area Allocated me a larger property . Other (please tell us) Transferred me to another property Made my home more secure Given me more choice about where I lived

Q7.

How do you feel about the service you received from Optima whilst a tenant?

Very Satisfied
Q8. Q9.

Satisfied

Dissatisfied

Very Dissatisfied
Yes Yes No No

Would you recommend Optima to friends and family? Would you consider taking an Optima property again? If no, can you say why?

NOTICE OF TENANCY TERMINATION To Optima Community Association, St Thomas House, 80 Bell Barn Road, Birmingham, B15 2AF I/ we of address] [insert name(s)] [insert your

Hereby give you 28 days NOTICE OF INTENTION TO QUIT the tenancy above commencing on the (write in todays date below). ____________________________________ My tenancy will end on expiry of the notice on [write in below first Monday after expiry of 28 days from today]. _________________________________and I will hand in the keys before 12.00 midday on this date. Name and address of the person surrendering the keys (if not the tenant) is: ______________________________________________________________________ When my tenancy ends I understand that I am responsible for leaving behind the following items in a serviceable condition: Electric light fittings and sockets Internal and external doors All kitchen fixtures and fittings All bathroom fixtures and fittings All cupboards Existing form of heating Existing hot water system I undertake not to remove any of the above fixtures when I leave the premises, and if any of these items are missing or in a poor condition, I realise that I am responsible for the cost of replacement and will be charged accordingly. I also accept that I will be charged for any repairs that might be necessary at the property if they are not the result of fair wear and tear. I also understand that my Tenancy Agreement requires me to leave the dwelling in a clean and tidy condition with all doors and windows secure, with gas, electric and water services left in a safe condition and that I will be responsible for the of removal of any rubbish, including carets, floor coverings and curtains not provided by Optima, and all of my personal belongings. I give permission to dispose of anything left in the property and accept that I will be charged for any costs incurred by Optima for disposing of those items. I also understand that if I have a garden I must leave it in a tidy condition and free of rubbish and/or personal belongings.

I agree to an inspection of the property before I leave which has been booked for: __________________________________________ Reason for leaving Forwarding Address: _________________________________________________________________ Rent account checked Agreement made: Please write your garage address here if applicable: _______________________________________________________________ Y/ N. Arrears

Signature (Tenant): Signature (Tenant): Optima officer:

_______________________________ _______________________________

Date: _________________________ COPY OF NOTICE MUST BE GIVEN TO TENANT

Please note if you are a joint tenant then only one of the joint tenants needs to sign the Notice for the whole tenancy to end on the termination date.

You must return all keys to your property including any garage keys. Failure to do so will result in a charge for any locks that need to be changed.

Cancellation of Notice to Vacate. If you wish to cancel this notice you must contact Optima before the date of termination. Optima reserves the right to refuse any request to cancel this notice.

KEYS RETURNED Address Front door Rear door Balcony door Window locks Kitchen cupboard door locks Keyfobs Store room keys Garden shed keys Side entry gate (ginnel keys) Garage keys (check tenancies on Orchard) Car park space keys (Ottawa tower /Stone road) Car park electronic keyfobs (Lee Bank only) If 5 Ways property they should return 4 car park passes please note reason for non return If Stone Road property they should return 4 car park permits Gas/electric meter cupboard keys Any other keys Explain here if keys not received from tenant eg received via post or an eviction etc. Any actions required Number of keys

Name of officer receiving keys Signature of tenant Date keys returned Once this is completed a copy must be given to the tenant.