If you are unable to resolve an off-campus housing issue directly, complete this form to receive assistance from Off-Campus Living & Commuter Services. Complaint Details Date of problem Complaint Contact Information First name Last name Email address Phone number Current Address Street address P.O. Box or apartment number (optional) City State ZIP code Campus Affiliation Campus Affiliation Off-campus living student Landlord Concerned friend/neighbor Rental Property Information (optional) Landlord name Street address City State ZIP code Certification I certify I certify that the information provided in this complaint is true and accurate. Signed Date