# DECLINATION DECLARATION

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URL: https://www.frixlaw.com/law-library/documents/tribal%3Agrand_traverse%3A0abf56ea3596b7cb

## Record

- **Collection:** Tribal code
- **Document type:** Tribal code

## Text

APPENDIX 49

Sample Letter

DECLINATION
DECLARATION
STATEMENT
DECLINATION DECLARATION
STATEMENT

MUTUAL HELP PROGRAM

BUY OUT OFFER

4
am the named SUCCESSOR to the Mutual Help Unit formally occupied by
and located at

After reviewing my options, | have elected to Decline the opportunity to BUY OUT the
balance of the Mortgage on this Mutual Help home.

SO OG a G, UTTae
financial accounts.

| also understand that the home will be reclaimed by the Grand Traverse Band Tribal!
Housing Department, refurbished, and made available to the next “eligible” family on

the Mutual Help Waiting List.

(Signature of Successor) (Date)
Notary Seal
(Signature of Notary) (Date)
My commission expires on:
‘(Date)

GTBHD Form Letter # 64
04/02/02
APPENDIX 50

Sample Letter

REQUEST
for
TEMPORARY ABSENCE
DATE:

(Enter Date)

FROM:

(Clients Name)
TO: Grand Traverse Band Housing Department
SUBJ: REQUEST FOR TEMPORARY ABSENCE

It is necessary for me to be gone from my dwelling unit for a short period of time and
during that time, | would like to request a Temporary Absence so as not to loose the

dwelling unit.

Name of Head of Household:

Dwelling Unit Number / Apartment Number:

Dwelling Unit Location:

Current Mailing Address:

Current Phone Number:

Dates of Absence: From to

Reason for Absence:

| understand that this request can be for no more than ninety (90) calendar days. If it
goes beyond 90 days, the Housing Department shall reclaim the unit.

(Signature of Head of Household)

] GTBHD Form Letter # 63
04/0202
HOUSING DIRECTOR REVIEW

REVIEWED BY THE HOUSING DIRECTOR ON:

REQUEST HAS BEEN: _ [_] Approved
[-] Dis-Approved

COMMENTS:

(Signature - Housing Director)

cc: Resident Services Manager
Client File

2 GTBHD Form Letter # 63
04/02/02
APPENDIX 51

Sample Letter

INTENT
to
VACATE
DATE:

(Enter Date)

FROM:

(Clients Name)

TO: Grand Traverse Band Housing Department

SUBJ: Intent to Vacate

Per the terms and conditions of my Rental Lease / Homebuyer (MHOA) Agreement, this
letter is being submitted to serve notice of my intent to vacate my dwelling unit.

Name of Head of Household:

Dwelling Unit Number / Apartment Number:

Dwelling Unit Location:

Current Mailing Address:

Current Phone Number:

Forwarding Address:

Vacate Date:

Reason for Vacating ( Optional):

| would like to request a Pre-Move-Out Inspection: [_] Yes

(Signature of Head of Household)

[_] No

GTBHD Fonm Letter # 65
04/02/02
APPENDIX 532

Sample Letter

TERMINATION |
of
LEASE
NOTICE
Grand Traverse Band
of Ottawa and Chippewa Indians
Housing, Department [Xx .
2605 N. West Bayshore Dr.
Peshawbestown, MI 49682
Office: 231/271-4473 Fax: 231/271-2025

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4 \)
dataaet NS

NOTIFICATION OF
(Name of Client) | - . TERMINATION
(Address) i OF
LEASE AGREEMENT
(City, State, ZIP) °
Dear (Date)

Pursuant to your Rental Lease / Mutual Help and Occupancy (MHOA) Agreement, executed by
you with the Housing Department on _ , you are hereby
notified that your Rental Lease / Mutual Help and Occupancy (MHOA) Agreement to the
dwelling unit located at: «unit numbem, «unit area / city», is being terminated, effective thirty-

(30) calendar days from the date of this letter («date»).

The reason(s) your Rental Lease / Mutual Help and Occupancy (MHOA) Agreement is being
terminated are as follows:

You must vacate the property on or before («date»), as stated above. The property must be left
in a clean and good condition. The keys must be returned to the Housing Department. You
shall be responsible for any costs associated with repairs and / or clean up of the dwelling unit

Your failure to vacate the property shall result in EVICTION proceedings in Grand Traverse
Band Tribal Court. If court action is necessary, the Housing Department shall request that
you pay all legal fees, court costs, and attorney fees associated with the EVICTION.

If you wish to appeal the termination of your Rental Lease / Mutual Help and Occupancy
(MHOA) Agreement you must request a hearing. The request must be in writing, and submitted
within ten (10) calendar days of receipt of this notice. Your request must contain the reason(s)
for your appeal and must be delivered to the Housing Department. If your request for appeal
meets the above conditions, a hearing shall be scheduled at least five (5) calendar days prior to
the effective termination date of the Rental Lease / Mutual Help and Occupancy (MHOA)

Agreement.

Sincerely,

Housing Director

cc: Housing Attorney’s Office, Resident Services Manager, Client File
GTBHD Form Letter # 23
06/01/02

GRAND TRAVERSE CHARLEVOIX LEELANAU BENZIE MANISTEE ANTRIM
DATE:

(Enter Date)

FROM:

(Clients Name)
TO: Grand Traverse Band Housing Department

SUBJ: Intent to Vacate

Per the terms and conditions of my Rental Lease / Homebuyer (MHOA) Agreement, this
letter is being submitted to serve notice of my intent to vacate my dwelling unit.

Name of Head of Household:

Dwelling Unit Number / Apartment Number:

Dwelling Unit Location:

Current Mailing Address:

Current Phone Number:

Forwarding Address:

Vacate Date:

Reason for Vacating (Optional):

| would like to request a Pre-Move-Out Inspection: [[] Yes [] No

(Signature of Head of Household)

GTBHD Fonm Letter # 65
04/02/02
APPENDIX 53

Sample Form

UNIT TRANSFER
REQUEST
FORM
Grand Traverse Band

of Ottawa and Chippewa Indians
Housing, Department IX
2605 N. West Bayshore Dr.
Peshawbestown, MI 49682
Office: 231/271-4473 Fax: 231/271-2025

REQUEST FOR UNIT TRANSFER

TENANT NAME:

MAILING ADDRESS:

TELEPHONE NR: HOME: - WORK: -
YOUR CURRENT HOUSE NR: PROJECT NAME:
LOCATION:
(Pine View, River Falls, Bass Lake, etc.)
TYPE OF UNIT [ | Increase/Decrease in Family Size [| Emergency
TRANSFER
REQUEST: [] Medical [_] GangViolence [_] One-for-One Swap
| am requesting a transfer from a bedroom unit to a _ bedroom unit.

The circumstances, under which | am making this transfer request, are as follows:

(Use Additional Pages if Required)

ACKNOWLEDGMENTS
A. | understand that | am responsible for ALL Costs associated with moving, to
include cleaning, damages, repairs, etc. to my current residence.
B. | agree to pay for those costs as a pre-condition for consideration of this transfer
request.

] GTBED Fon # 11
04/02/02

GRAND TRAVERSE | CHARLEVOIX LEELANAU BENZIE MANISTEE ANTRIM
C. | understand that this cleaning and repair work must be done before the transfer
can take place.

D. | certify that | have NO ARREARAGES with my housing account or any Utility
Company. My current utility providers are:
ELEC: #8 es LP:
(Tenant Signature) (Date)

HOUSING DEPARTMENT USE ONLY ~

DATE RECEIVED: DATE REVIEWED:

RESIDENT SERVICES STAFF COMMENTS:

¢ .

CLIENTS. HOUSING DEPARTMENT FUNDWARE ACCOUNT CHECKED FOR ARREARS.

CURRENT BALANCE: $ AS OF VERIFIED BY:
(Enter Amount) (Date) (Staff Initials)

UTILITIES — GAS - CHECKED FOR ARREARS BY SENDING UTILITY VERIFICATION .

NAME OF COMPANY:

CURRENT BALANCE: $ AS OF VERIFIED BY:
(Enter Amount) (Date) (Staff Initials)

2 GTBHD Form # 1
04/02/02
UTILITIES — ELECTRIC - CHECKED FOR ARREARS BY SENDING UTILITY VERIFICATION.

NAME OF COMPANY:
CURRENT BALANCE: $ AS OF VERIFIED BY:

(Enter Amount) (Date) (Staff Initials)
¢ —%
REVIEWED BY DIRECTOR ON: INITIALS:

DIRECTORS COMMENTS:

cc: Resident Services Manager
Maintenance Division Manager
Rehabilitation Division Manager
Client File

3 GTBHD Form # 11
04/02/02
REQUEST FOR UNIT TRANSFER
ONE-FOR-ONE SWAP

, the Lease Holder for the

(Lease Holder Name)

bedroom rental unit , located in
(NR of Bedrooms) . (House/Apt NR) (Project Name or Area)
and , the Lease Holder for the
(Name of Other Lease Holder )
bedroom rental unit , located in
(NR of Bedrooms) (House/Apt NR) (Project Name or Area)

have agreed to a one-for one swap of units.

ACKNOWLEDGMENTS
4. | understand that | must accept in an “AS IS” condition.
(House/Apartment Number) ,
2. | understand that for record keeping purposes, this transfer must take place on the ‘st of
the month. .
3. — | agree to pay for all moving expenses incurred as a result of this transfer request.
4. | agree to take responsibility for notifying the utility and L.P. Gas companies of this

transfer prior to the scheduled move date.

5. | agree to have the Housing Department document the condition of my old home
(MOVE-OUT INSPECTION) and the condition of my new home (MOVE-IN
INSPECTION) within forty-eight (48) hours of the scheduled move date.

6. | agree to pay for any expense, resulting from this unit transfer, which may be incurred
by the Housing Department and that is my responsibility.

(Lease Holder Signature) (Date)

GTBHD Form # 12
04/02/02
HOUSING DEPARTMENT USE ONLY

DATE RECEIVED: DATE REVIEWED:

RESIDENT SERVICES STAFF COMMENTS:

FORWARDED TO DIRECTOR ON: INITIALS:

REVIEWED BY DIRECTOR ON: INITIALS:

DIRECTORS COMMENTS:

ce: Maintenance Division
Resident Services Manager
Client File

GTBHD Fonn # 12
04/02/02
APPENDIX 54

Sample Letter

DIRECT T.V.
SATELLITE DISH
INSTALLATION
DATE:

(Enter Date)

FROM:

(Clients Name)
TO: Grand Traverse Band Housing Department

SUBJ: Request to Install DIRECT T.Y. SATELLITE DISH

Per the terms and conditions of the Grand Traverse Band Housing Department
Occupancy Policy, | would like to request permission to install a DIRECT T.Y.

SATELLITE DISH at my dwelling unit.

Name of Head of Household:

Dwelling Unit Number / Apartment Number:

Dwelling Unit Location:

Current Mailing Address:

Current Phone Number:

| have read Section 46 (entitled: 7.V. Reception Options) of the Gray Wolf Tribal
Housing Department’s Occupancy Policy and understand what my responsibilities are

with regards to proper installation of a DIRECT T.V. SATELLITE DISH, paying for the
installation, and removing / disposing of the Dish / Cabling upon Move-Out.

(Signature of Head of Household)

1 GTBHD Form Letter # 66
04/07/02
HOUSING DIRECTOR REVIEW

REVIEWED BY THE HOUSING DIRECTOR ON:

REQUEST HAS BEEN: [-] Approved
[_] Dis-Approved

COMMENTS:

(Signature - Housing Director)

Distribution: Original to Clients Resident Services File
Copy to Clients Maintenance Division File
Copy to Client

2 CTBHD Form Letter # 66
oaoa/o2
APPENDIX 55

Sample Letter

SATELLITE DISH
INSTALLATION
DATE:

(Enter Date)

FROM:

(Clients Name)

TO: Grand Traverse Housing Department

SUBJ: Request to Install SATELLITE DISH

Per the terms and conditions of the Grand Traverse Band Housing Department
Occupancy Policy, | would like to request permission to install a SATELLITE DISH at my
dwelling unit.

Name of Head of Household:

Dwelling Unit Number / Apartment Number:

Dwelling Unit Location:

Current Mailing Address:

Current Phone Number:

| have read Section 46 (entitled: 7.V. Reception Options) of the Grand Traverse Band
Housing Department’s Occupancy Policy and understand what my responsibilities are

with regards to proper installation of a SATELLITE DISH, paying for the installation, and
removing / disposing of the Dish / Cabling upon Move-Out.

(Signature of Head of Household)

1 GTBHD Form Letter # 67
04/07/02
HOUSING DIRECTOR REVIEW

REVIEWED BY THE HOUSING DIRECTOR ON:

REQUEST HAS BEEN: [-] Approved
[_] Dis-Approved

COMMENTS:

(Signature - Housing Director)

Distribution: Original to Clients Resident Services File
Copy to Clients Maintenance Division File
Copy to Client

GTBHD Form Letter # 67
04/02/02
APPENDIX 56

Sample Letter

T.V. ANTENNA
INSTALLATION
DATE:

(Enter Date)

FROM:

(Clients Name)

TO: Grand Traverse Band Housing Department

SUBJ: Request to Install a T.V. ANTENNA

Per the terms and conditions of the Grand Traverse Band Housing Department
Occupancy Policy, | would like to request permission to install a T.V. ANTENNA at my

dwelling unit.

Name of Head of Household:

Dwelling Unit Number / Apartment Number:

Dwelling Unit Location:

Current Mailing Address:

Current Phone Number:

| have read Section 46 (entitled: 7.V. Reception Options) of the Grand Traverse Band
Housing Department’s Occupancy Policy and understand what my responsibilities are

with regards to proper installation of a T.V. ANTENNA, paying for the installation, and
removing / disposing of the Dish / Cabling upon Move-Out.

(Signature of Head of Household)

1 GTBHD Form Letter # 68
04/02/02
HOUSING DIRECTOR REVIEW

REVIEWED BY THE HOUSING DIRECTOR ON:

REQUEST HAS BEEN: [-] Approved
[_] Dis-Approved
COMMENTS:

(Signature - Housing Director)

Distribution: Original to Clients Resident Services File

Copy to Clients Maintenance Division File
Copy to Client

2 GTBHD Form Letter # 68
04/02/02
APPENDIX 37

Sample Letter

NOTIFICATION
of |
NEED FOR YARD UPKEEP
Grand Traverse Band
of Ottawa and Chippewa Indians
Housing, Department IX .
2605 N. West Bayshore Dr.
Peshawbestown, MI 49682 ee, Depart ag
Office: 231/271-4473 Fax: 231/271-2025

Established S
tg Cy
1980 >
eet »

sve

eZ

NOTIFICATION

(Name of Client)
Of

NEED FOR YARD UPKEEP

(Address)

(City, State, ZIP) (Date)

Dear

It has come to the attending of Grand Traverse Band Housing Department
management that you have not been keeping your yard up to the standards set forth in
our Occupancy Policy, and by which you agreed to abide.

We have determined that, dwelling unit number , located in the
housing area needs:

[] The Grass Cut
To have Debris-cleared from the Yard

L]
[] To have Snow Shoveled .
[] Other

You have seventy-two (72) hours, from the date of this notice, to complete this
work or the Housing Department shall make arrangements to have the work done on
your behalf. You will, however, be billed for the full cost of the service.

You are also advised, that continued non-compliance is grounds for Termination
of your Rental Lease / Homebuyer (MHOA) Agreement and Eviction.

If you have any questions, please call the Housing Department at (231) 271-
4473.

Sincerely,

Housing Pepariment Staff Signature

cc: Client File

GIBB Form Letter # 70
04/02/02

SRAND TRAVERSE CHARLEVOIX LEELANAU BENZIE MANISTEE ANTRIM
APPENDIX 58

Sample Letter

VISITOR |
ACCOMMODATIONS
REQUEST
DATE:

(Enter Date)

FROM:

(Clients Name)
TO: Grand Traverse Band Housing Department

SUBJ: Visitor Accommodations Request

Per the terms and conditions of my Rental Lease / Homebuyer (MHOA) Agreement and
the Grand Traverse Band Housing Department Occupancy Policy, | would like to

request permission to have visitors in my dwelling unit.

Name of Head of Household:

Dwelling Unit Number / Apartment Number:

Dwelling Unit Location:

Current Mailing Address:

Current Phone Number:

Visitor Information:

Name:
Age:
Relationship to Lease Holder:
Length of Stay:

Name:
Age:
Relationship to Lease Holder:
Length of Stay:

Name:
Age:
Relationship to Lease Holder:
Length of Stay:

Name:
Age:
Relationship to Lease Holder:
Length of Stay:

1 GTBRD Form Letter # 69
04/02/02
| have read Section 52 (entitled: Visitor Accommodations) of the Grand Traverse Band
Housing Department’s Occupancy Policy and understand what my responsibilities are
with regards to visitor accommodations. | also understand that if my visitors stay
beyond 30 calendar days, they must undergo the eligibility and screening process as
outlined in the Housing Department Admissions Policy.

(Signature of Head of Household)

HOUSING DIRECTOR REVIEW

REVIEWED BY THE HOUSING DIRECTOR ON:
REQUEST HAS BEEN: [-] Approved
[_] Dis-Approved

COMMENTS:

(Signature - Housing Director)

Distribution: Original to Clients Resident Services File
Copy to Client

2 GTBHD Fonm Letter # 69
04/02/02
[OCR skipped on page(s) 31-32]

[Read from a scan; the first 30 pages.]

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Source: Frix Law Library, https://www.frixlaw.com/law-library/documents/tribal%3Agrand_traverse%3A0abf56ea3596b7cb. Public record. Not legal advice.