Relocation Services Request

Department

Contact Name

Contact Phone (please include area code)

Contact Email

Billing Department

Billing Contact Name

Billing Contact Phone (please include area code)

Billing Contact Email

Name

City moving from

Phone Number(s)

Email

University of Texas at Austin Job Title

Has the prospective employee accepted the position? (Answering no indicates the prospective employee is in the recruitment/interview process.)
Yes
No

Is your department paying for the move?
Yes
No

If yes, how much is allotted?

(If more than one department is contributing, please enter total amount here. Then list each contribution separately by department in the special instructions.)

$

Start date of employment:

(Note: Tour may be requested before relocation details are finalized.)

Will the new employee come to campus and need a tour before accepting a position?
Yes
No

If yes, please explain:

Any other special instructions or information: