Sample Request for Exception
6-15-05
To: ____________, District Supervisor.
____________, Assistant Deputy Director
From: _____________, Vocational Rehabilitation Counselor
This is a "time critical" request for an exception to established maintenance policy so that Lions World Services for the Blind may advance funds to cover relocation expenses for Mr. John Smith. Currently, the RSB contract with LWSB does not include Funds Advancement for Relocation Expenses for Employment.
Mr. Smith was recently hired by Lions World Services for the Blind at the end of his customer service internship. Mr. Smith’s permanent address is in Southeast Missouri. He began his employment on June 13, 2005. He’s made application for a one bedroom apartment, close to the LWSB campus and needs to move to the apartment on July 1, 2005 so that he is able to get to work.
Mr. Smith has no income other than $199 per month Veteran’s disability payment. He has no cash reserves and cannot afford to pay the required security deposit, first month’s rent, and electric service deposit needed to hold and move in the apartment on July 1, 2005.
The above named expenses are:
Application fee - $35.00
Security deposit - $425.00
One month’s rent - $425.00
Electric service deposit - $160.00
Total of $1045.00
Mr. Smith is continuing to reside at the LWSB facility until he can secure the apartment. Since he now is an LWSB employee, it is imperative he get moved off the campus as soon as possible.
Additionally, RSB is paying $31.50 per day room and board for Mr. Smiths' continued residing at LWSB. From his employment start date of June 13 through June 30, 2005 this will cost $535.50. We do not want to incur any additional charges at the facility for the month of July.
Please expedite an approval of this request for an exception to RSB maintenance policy and approve authorization to reimburse LWSB for advancement of funds to cover stated relocation expenses to Mr. Smith.
Signature of Counselor:_____________________
Signature of District Supervisor:___________________
Signature of Assistant Deputy Director:____________________