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INFORMATION Resident Name Housing Date Stamp Please print legibly UH ID #/SSN Date of Notification Letter/Billing/Action Current Mailing Address (Street) City State Email Address hawaii.edu Current Home Phone: Cell Phone/Pager: Hall: Room/Apt # Term/Year: Fall Spring Summer Zip Code Other: Specify APPEAL INFORMATION Type of Appeal: check one item only Financial Examples: Room Rental, Late Fee, Damages, Improper Check-Out,.

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