UIS Department of Residence Life Appeal Form
Please submit your damage appeal below.
If you are appealing multiple damages for different reasons, you may have to submit this form more than once.

All appeals will be reviewed starting after June 4th. You will be notified of the outcome of your appeal by June 14th. If your appeal is approved, you will be refunded the amount billed but will be responsible for any fees associated with non-payment. Please pay your bill (by the University established due dates) in full to avoid these charges; if you have a credit on your account, you can request a check be cut or can apply your balance to future bills.

We strongly encourage you to submit your damage appeal by June 4th or within 30 days of your checkout. Appeals sent after the indicated time frame will not be accepted.

Include all your information below and make the appropriate selections to indicate your type of appeal. Please submit all requested information or your appeal may be denied.

If you experience any trouble with this form, please send your information, including your name, UIN, and a description (including grounds for your appeal) to reslife@uis.edu.

Name *
Please include your full name.
Your answer
UIN# *
Your answer
Spring 2017 Assignment *
Please include your complete campus assignment (building, apartment, room # or letter).
Your answer
Type of Appeal *
Please select from the following.
Which charge(s) are you appealing? *
Please list the specific charge(s) and explain why you are appealing the damage charge(s). You may also choose to submit photographs to reslife@uis.edu so the staff can compare against their own written and photographic evidence.
Your answer
Additional Information
Please indicate any additional information you deem necessary to assist with an appeal decision. Please include detailed information, especially if you selected "correct charges" OR "dispute charges" above if you would like your appeal considered.
Your answer
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