MICHA Member Notice to Terminate Occupancy

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Date(Required)

Resident’s Name(Required)

First Last

This is notice of my/our intent to terminate the current occupancy agreement on unit:

Building(Required)

Unit(Required)

Co-Op Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Member Share(Required)

I/We understand that MICHA has the first option but not the obligation to purchase the member share. Therefore my/our asking price for the member share is:

New Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country