JHMI PARKING SERVICES
 ADJUSTMENTS AND CANCELLATION FORM

 This form will allow you to make adjustments to personal information (i.e., home address,
 work phone, etc.) or cancel your parking. NOTE: If you are taking a Leave of Absence or  Rotation, please submit the "Leave of Absence/Rotation Form" - DO NOT USE THIS FORM.

(Print this form, complete and fax to 410-502-3907 or submit in person at the Parking Office located in Harvey 108).

Date: ____________________
Name: ______________________________________________________________
Social Security Number: ______- ______- _______
ID Badge Number: ___________________
E-mail Address: ______________________
Current Parking Assignment: ____________________________________________________
Employer: ________________________________________________________________
Effective Date for Changes: ____________________
 
INDICATE APPLICABLE CHANGE(S) BELOW
 
CHANGE CURRENT EMPLOYER
From: _______________________________________________ Work Phone: ___________________
To: __________________________________________________ Work Phone: ___________________
I
CHANGE PERSONAL INFORMATION (provide new/updated info below)
Street Address: ______________________________________________________________
City: _______________________________ State: __________ Zip: _______________
Home Phone: ___________________
 
CANCEL PARKING
Effective Date: ____________________
Reason for Cancellation: