Rent To Own Agreement
Rent To Own Agreement
Rent To Own Agreement
RENT-TO-OWN AGREEMENT
This Rent-to-Own Agreement (this “Agreement”) is made and entered into as of this _____ day of
_______________, 20_____, by and among/between:
Each Landlord or Seller and Tenant or Buyer may be referred to in this Agreement individually as a
“Party” and collectively as the “Parties.”
WHEREAS, Landlord desires to lease the Premises to Tenant upon the terms and conditions as
contained herein; and
WHEREAS, Tenant desires to lease the Premises from Landlord on the terms and conditions as
contained herein; and
WHEREAS, Tenant also desires to obtain an option to purchase the Premises at an agreed upon
purchase price (the “Option to Purchase”), and has agreed to certain additional property maintenance
conditions in consideration of the Option to Purchase; and
WHEREAS, Landlord desires to grant to Tenant the Option to Purchase pursuant to the terms and
conditions set forth herein.
NOW, THEREFORE, for and in consideration of the covenants and obligations contained herein and
other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the
Parties hereto hereby agree as follows:
1. Premises. The Premises is a/an (Check one) ☐ apartment ☐ house ☐ condominium ☐room
☐ townhouse ☐ duplex ☐ semi-detached house ☐ other: _____________ with:
(a) _____ bedroom(s)
(b) _____ bathroom(s)
(c) _____ parking space(s) ☐ Parking is not included with the Premises
2. Term. Landlord agrees to lease to Tenant, and Tenant agrees to lease from Landlord, the Premises for
a term beginning on _______________, 20_____ and: (Check one)
☐ (If Fixed Lease) Ending on _______________, 20_____ (the “Term”). At the end of the Term: (Check
one)
☐ A month-to-month holdover tenancy will be created it. If Landlord accepts a rent payment
from Tenant, other than past due rent or additional rent, after the Term expires, both parties
understand that a month-to-month holdover tenancy will be created at the agreed upon monthly
rent, unless proper notice has been served as required by applicable laws. If either Tenant or
Landlord wishes to end the month-to-month tenancy, such Party must provide at least thirty (30)
days’ written notice before the desired termination date.
☐ The Tenant must vacate the Premises. Unless this Agreement has been extended by mutual
written agreement of the Parties or Tenant has exercised the Option to Purchase, there will be no
holding over past the Term under the terms of this Agreement under any circumstances. If it
becomes necessary to commence legal action to remove Tenant from the Premises, the
prevailing Party will be entitled to attorney’s fees and costs in addition to damages.
☐ (If Month-to-Month Lease) Continuing month-to-month until either Landlord or Tenant terminate this
Agreement by providing the other Party with proper written notice of termination (the “Term”).
The Term is subject to the Option To Purchase the Premises given to Tenant by Landlord as more
particularly herein.
3. Rent. Tenant will pay to Landlord a monthly rent of $__________ for the Term. Rent will be payable in
advance and due on the __________ day of each month during the Term. Rent will be paid to Landlord at
________________________________________ by mail or in person by: (Check one) ☐ Personal
check ☐ Cashier's check ☐ Money order ☐ Cash ☐ PayPal ☐ Credit card or debit card
☐ Other: _______________, and will be payable in U.S. Dollars. Tenant shall pay to Landlord the
amount of $__________ in the event that any rent check or other payment made to Landlord hereunder is
returned by the bank unpaid due to insufficient funds or returned for any reason.
☐ In the event that any payment required to be paid by Tenant hereunder is not made within _________
days of when due, Tenant shall pay to Landlord, in addition to such payment or other charges due
hereunder, a late charge of (Check one) ☐__________% of the balance due per day for each day that
rent is late ) ☐$__________.
6. Additional Rent. There may be instances under this Agreement where Tenant may be required to pay
additional charges to Landlord. All such charges are considered additional rent under this Agreement and
will be paid with the next regularly scheduled rent payment. Landlord has the same rights and Tenant
has the same obligations with respect to additional rent as they do with rent.
7. Utilities. Tenant is responsible for arrangement and payment of all utility and other services for the
Premises, with the exception of the following, which will be PAID BY THE LANDLORD:
☐ Electric ☐ Water
☐ Gas ☐ Trash
☐ Telephone ☐ Sewage
☐ Cable ☐ Heat
☐ Internet ☐ Hot water
☐ Other:______________
8. Security Deposit. Upon the execution of this Agreement, Tenant will pay a security deposit to
Landlord in the amount of $__________ (the “Security Deposit”). The Security Deposit will be retained by
Landlord as security for Tenant’s performance of its obligations under this Agreement, including for any
damage caused to the Premises during the Term. If Tenant does not comply with any of the terms of this
Agreement, Landlord may apply any or all of the Security Deposit to remedy the breach, including to
cover any amount owed by Tenant and/or any damages or costs incurred by Landlord due to Tenant’s
failure to comply. The Security Deposit may not be used or deducted by Tenant as the last month’s rent
of the Term. The Security Deposit (Check one) ☐ will not ☐ will bear interest while held by the
Landlord in accordance with applicable state laws and/or local ordinances.
9. Return of Security Deposit. If Tenant returns possession of the Premises to Landlord in the same
condition as accepted, ordinary wear and tear excepted, Landlord will return the Security Deposit to
Tenant, less any allowed deductions, within __________ days after the end of the Term. Any reason for
retaining a portion of the security deposit will be itemized and explained in writing. If Tenant exercises the
Option to Purchase, the Security Deposit: (Check one)
☐ Will be credited towards the Purchase Price at the Closing (as defined herein).
☐ Will be returned to Tenant in accordance with this Agreement.
10. Use of Premises. The Premises shall be used and occupied by Tenant and Tenant’s immediate
family and used only for residential purposes. Tenant will not engage in any objectionable conduct,
including behavior which will make the Premises less fit to live in, will cause dangerous, hazardous or
unsanitary conditions or will interfere with the rights of others to enjoy their property. Tenant will be liable
for any damage occurring to the Premises and any damage to or loss of the contents thereof which is
done by Tenant or Tenant’s guests or invitees.
Guest/Visitor policy: ___________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
11. Condition of Premises. Tenant represents and warrants that Tenant has examined the Premises,
and that at the time of the execution of this Agreement, the Premises is in good order and repair, normal
wear and tear excepted, and in a safe, clean and tenantable condition. Tenant accepts the Premises in
the current condition, except: ___________________________________________________________
___________________________________________________________________________________.
☐ In order to avoid disagreements about the condition of the Premises, at the time of accepting
possession of the Premises, Tenant will complete the Inspection Checklist incorporated herein by
reference and attached hereto as Exhibit A and record any damage or deficiencies that exist at the
commencement of the Term. Landlord will be liable for the cost of any cleaning or repair to correct
damages found at the time of the inspection. Tenant will be liable for the cost of any cleaning and/or
repair to correct damages found at the end of the Term if not recorded on the inspection checklist, normal
wear and tear excepted.
13. Maintenance and Repairs. Tenant will, at its sole expense, keep and maintain the Premises,
including the grounds and all appliances and fixtures, in clean, sanitary and good condition and repair
during the Term. Tenant will not remove any appliances or fixtures from the Premises for any purpose. If
other repairs are required, Tenant will notify Landlord for such repairs.
14. Alterations. Tenant will not make any alteration, addition or improvement to the Premises without first
obtaining Landlord’s written consent. Any and all alterations, additions or improvements to the Premises
are without payment to Tenant and will become Landlord’s property immediately on completion and
remain on the Premises, unless Landlord requests or permits removal, in which case Tenant will return
that part of the Premises to the same condition as existed prior to the alteration, addition or improvement.
Tenant will not change any existing locks or install any additional locks on the Premises without first
obtaining Landlord's written consent and without providing Landlord a copy of all keys.
15. Compliance. Tenant agrees to comply with all applicable laws, ordinances, requirements and
regulations of any federal, state, county, municipal or other authority.
16. Rules and Regulations. Landlord has prescribed the rules and regulations governing Tenant’s use
and enjoyment of the Premises, attached hereto as Exhibit B, and incorporated by reference herein.
Tenant acknowledges receipt of and agrees to adhere to such regulations.
☐ Smoking of any kind is strictly prohibited on any part of the Premises. This prohibition applies to
Tenant and any visitor, guest or other occupant on the Premises.
☐ Tenant is NOT allowed to have or keep any pets, even temporarily, on any part of the Premises.
19. Right of Entry. Landlord or its agents may enter the Premises at reasonable times to inspect the
Premises, to make any alternations, improvements or repairs or to show the Premises to a prospective
tenant, buyer or lender. In the event of an emergency, Landlord may enter the Premises at any time.
☐ Tenant can assign this Agreement, or sublease or grant any license to use the Premises or any part
thereof without obtaining Landlord’s prior written consent.
☐ Tenant shall not assign this Agreement, or sublease or grant any license to use the Premises or any
part thereof without obtaining Landlord’s prior written consent.
☐ Tenant shall NOT assign this Agreement, or sublease or grant any license to use the Premises or any
part thereof.
21. Reasonable Accommodations. Landlord agrees to comply with all applicable laws providing equal
housing opportunities, including making reasonable accommodations for known physical or mental
limitations of qualified individuals with a disability, unless undue hardship would result. Tenant is
responsible for making Landlord aware of any such required accommodations that are reasonable and
will not impose an undue hardship. If Tenant discloses a disability and requests an accommodation,
Landlord has the right to have a qualified healthcare provider verify the disability if the disability is not
readily apparent, and Landlord has the right to use the qualified healthcare provider verifying the disability
as a resource for providing the reasonable accommodation.
22. Sex Offender Registry. Pursuant to law, information about specified registered sex offenders is
made available to the public. Tenant understands and agrees that Tenant is solely responsible for
obtaining any and all information contained in the state or national sex offender registry for the area
surrounding the Premises, which can be obtained online or from the local sheriff’s department or other
appropriate law enforcement officials. Depending on an offender’s criminal history, this information will
include either the address at which the offender resides or the community of residence and zip code in
which he or she resides.
23. Quiet Enjoyment. If Tenant pays the rent and performs all other obligations under this Agreement,
Tenant may peaceably and quietly hold and enjoy the Premises during the Term.
24. Hazardous Materials. Tenant shall not keep on the Premises any item of a dangerous, flammable or
explosive character that might unreasonably increase the danger of fire or explosion on the Premises or
that might be considered hazardous or extra hazardous by any responsible insurance company.
☐ The Premises was built prior to 1978. Housing built before 1978 may contain lead-based paint. Lead
from paint, paint chips and dust can pose health hazards if not managed properly. Lead exposure is
especially harmful to young children and pregnant women. Before renting pre-1978 housing, Landlord
must disclose the presence of known lead-based paint and/or lead-based paint hazards in the dwelling.
Tenant must also receive a federally approved pamphlet on lead poisoning prevention.
☐ The Tenant may terminate their lease early for active duty. In the event Tenant is, or hereafter
becomes, a member of the United States Armed Forces (the “Military”) on extended active duty, and
Tenant receives permanent change of station orders to depart from the area where the Premises is
located or is relieved from active duty, retires or separates from the Military, or is ordered into Military
housing, then Tenant may terminate this Agreement upon giving thirty (30) days written notice to
Landlord. Tenant shall also provide to Landlord a copy of the official orders or a letter signed by Tenant’s
commanding officer, reflecting the change which warrants termination under this Section. Tenant will pay
prorated rent for any days Tenant occupies the dwelling past the first day of the month rent is due. Any
security deposit will be promptly returned to Tenant, provided there are no damages to the Premises.
☐ The Tenant may NOT terminate their lease early for active duty.
☐ Tenant is required to obtain, and maintain at all times during the Term, a renter’s insurance policy with
a minimum of $100,000.00 personal liability coverage. Tenant will name Landlord as an interested party
or additional insured. Tenant will provide Landlord with a certificate or proof of insurance upon request
☐ Tenant understands and agrees that Tenant and anyone acting on Tenant’s behalf do NOT have the
right to file for mechanic’s liens or any other kind of liens on the Premises. Tenant agrees to give actual
advance notice to any contractors, subcontractors or suppliers of goods, labor or services that such liens
are invalid. Tenant further agrees to take the additional steps necessary to keep the Premises free of any
and all liens that may result from construction completed by or for Tenant.
☐ Tenant and anyone acting on Tenant’s behalf may file for mechanic’s liens or any other kind of liens
on the Premises.
29. Insurance Requirements. Tenant will not do or permit to be done any act or thing that will increase
the insurance risk under any policy of insurance covering the Premises. If the premium for such policy of
insurance increases due to a breach of Tenant’s obligations under this Agreement, Tenant will pay the
additional amount of premium as additional rent under this Agreement.
30. Subordination of Lease. This Agreement and Tenant's rights hereunder will be subordinate, junior
and inferior to any and all mortgages, liens or encumbrances now or hereafter placed on the Premises by
Landlord, all advances made under any such mortgages, liens or encumbrances (including, but not
limited to, future advances), the interest payable on such mortgages, liens or encumbrances and any and
all renewals, extensions or modifications of such mortgages, liens or encumbrances.
31. Liability. Landlord is not responsible or liable for, and Tenant hereby agrees to indemnify, defend and
hold Landlord harmless from, any loss, claim, damage or expense as a result of any accident, injury or
damage to any person or property occurring anywhere on the Premises, unless resulting from the
negligence or willful misconduct of Landlord.
32. Default. In the event of any default under this Agreement, Landlord may provide Tenant a notice of
default and an opportunity to correct such default. If the default is Tenant’s failure to timely pay rent or
additional rent as specified in this Agreement, Landlord may terminate this Agreement by giving a
__________ day written notice to Tenant. If Tenant fails to correct the default, other than a failure to pay
rent or additional rent, Landlord may terminate this Agreement by giving a __________ day written notice.
After termination of this Agreement, Tenant shall forfeit the credit, if any, Tenant would have received if
Tenant exercised the Option To Purchase and closed on the Premises. In addition, Tenant remains liable
for any rent, additional late, costs, including costs to remedy any defaults, and damages under this
Agreement.
33. Remedies If this Agreement is terminated due to Tenant’s default, Landlord may, in addition to any
rights and remedies available under this Agreement and applicable law, use any dispossession, eviction
or other similar legal proceeding available in law or equity.
34. Damage to Premises. If the Premises are damaged by fire or other serious disaster or accident and
the Premises becomes uninhabitable as a result, Tenant may immediately vacate the Premises and
terminate this Agreement upon notice to Landlord, including the Option to Purchase contained herein.
Tenant will be responsible for any unpaid rent or will receive any prepaid rent up to the day of such fire,
disaster or accident, but shall then be entitled to a refund of a pro-rata portion of the credit, if any, Tenant
would have received if Tenant exercised the Option To Purchase and closed on the Premises. If the
Premises are only partially damaged and inhabitable, Landlord may make full repairs and will do so within
a prompt and reasonable amount of time. At the discretion of Landlord, the rent may be reduced while the
repairs are being made.
35. Surrender of Premises. If Tenant does not exercise the Option to Purchase, Tenant will deliver and
surrender to Landlord possession of the Premises immediately upon the expiration of the Term or the
termination of this Agreement, clean and in as good condition and repair as the Premises was at the
commencement of the Term, reasonable wear and tear excepted. Tenant must return the keys to the
Premises to Landlord when Tenant vacates the Premises.
36. Option to Purchase. Landlord hereby grants Tenant the Option to Purchase the Premises “AS IS.”
The total purchase price for the Premises will be: (Check one)
☐ $__________ (the “Purchase Price”), subject to the terms and conditions set forth herein.
☐ Determined and agreed upon by the Parties at the later time (the “Purchase Price”), subject to the
terms and conditions set forth herein.
37. Option Term. The Option to Purchase period commences on _______________, 20_____ and
expires on _______________, 20_____.
38. Option Consideration. Tenant will pay consideration through: (Check one)
☐ A portion of the monthly rent. As consideration for the Option to Purchase, Tenant acknowledges that
Tenant is paying consideration to Landlord in the form of nonrefundable rent at the agreed upon monthly
amount set forth in this Agreement. Unless otherwise stated in this Agreement, this amount is
nonrefundable to Tenant.
☐ A nonrefundable upfront fee. As consideration for the Option to Purchase, Tenant agrees to pay to
Landlord a nonrefundable fee of $__________ (the “Option Fee”) at the execution of this Agreement.
Unless otherwise stated in this Agreement, the option payment is nonrefundable to Tenant.
Credit
Provided that the Tenant timely exercises the Option to Purchase, is not in default of this
Agreement and closes the conveyance of the Premises as set forth in this Agreement (the
“Closing”): (Check all that apply)
☐ The Option Fee shall be credited against the Purchase Price at the Closing.
☐ $__________ of the Option Fee shall be credited against the Purchase Price at the Closing.
☐ $__________ from each monthly lease payment that Tenant timely made prior to the Closing
shall be credited towards the Purchase Price at the Closing.
39. Notice of Exercising Option. To exercise the Option to Purchase, Tenant must deliver to Landlord
written notice of Tenant’s intent to purchase the Premises prior to the expiration of the Option to
Purchase. The written notice must specify a valid closing date for the purchase, which must occur before
the original expiration date of this Agreement, or the date of the expiration of the Option to Purchase,
whichever occurs later.
40. Exclusivity of Option. The Option to Purchase is exclusive and non-assignable and exists solely for
the benefit of Tenant. Should Tenant attempt to assign, convey, delegate, or transfer the Option to
Purchase without Landlord’s express written permission, any such attempt shall be deemed null and void,
and the Option to Purchase may voided at Landlord’s discretion, which shall subject all credits otherwise
due to Tenant at the Closing to be forfeited by Tenant.
41. Personal Property. The sale includes all of Seller’s right, title and interest, if any, to all real estate,
buildings, improvements, appurtenances and fixtures (except as described below). Fixtures shall include
all things that are embedded in the land or attached to any buildings and cannot be removed without
damage to the Property.
The following fixtures and items are excluded from the sale: ____________________________________
____________________________________________________________________________________
42. Inspection. If the Option to Purchase is exercised, Buyer is agreeing to purchase the Premises in “AS
IS” condition. As Buyer will have occupied the Premises for many years and will continue to occupy the
Premises up to the Closing Date, Buyer hereby waives all customary rights to inspection of the Premises
and any rights to cancel or otherwise decline to close the transaction, and the Buyer confirms that good
and adequate consideration exists for this waiver.
43. Closing and Settlement. The Purchase Price, subject to any credits, is payable by Buyer on the
Closing Date by one of the following methods (Check all that apply) ☐ Cash ☐ Cashier's check
☐ Certified check ☐ Wire transfer ☐ Other: _______________.
☐ Seller and/or Buyer. On or before the Closing, Seller shall pay: (Check all that apply)
☐ One half of any escrow or closing fees.
☐ All escrow or closing fees.
☐ All transfer taxes and conveyance fees.
☐ All costs of releasing any mortgage, financing statement, or other debt security.
☐ All costs of removing, remedying or curing any contingencies.
☐ All costs related to the preparation of the deed.
☐ Any broker commissions or fees.
☐ Any property gains tax, as required by federal or state law.
☐ Other: ____________________________________
On or before the Closing, Buyer shall pay: (Check all that apply)
☐ One half of any escrow or closing fees.
☐ All escrow or closing fees.
☐ All transfer taxes and conveyance fees.
☐ All costs related to the recording of the deed.
☐ All costs or expenses related to obtaining financing, including origination or commitment fees
and the lender’s title insurance policy.
☐ All other costs and expenses associated with this Agreement, unless otherwise agreed to by
the Parties.
☐ Other: ____________________________________
☐ Buyer only. Buyer agrees that all closing costs shall be the sole responsibility of Buyer.
44. Title. Seller shall convey marketable title to Premises, by delivering a good and sufficient general
warranty deed in fee simple absolute, on or before the Closing. (Check one) ☐ Seller ☐ Buyer shall
obtain a title insurance policy (the “Title Policy”) by a title insurance company selected by (Check one)
☐ Seller ☐ Buyer which is authorized to do business in _________________ [State of property] (the
“Title Company”), subject only to: (Check all that apply)
☐ Any and all restrictions, limitations, regulations, ordinances and/or laws imposed by any
governmental authority and any and all other provisions of any governmental restrictions, limitations,
regulations, ordinances and/or public laws.
☐ Any liens for real property taxes or assessments created or attaching between the date of the Title
Policy and the date the deed or instrument of transfer is recorded.
☐ Any material defect, lien or encumbrance created, suffered, assumed or known by the Buyer.
☐ Any rights of eminent domain.
☐ Any claim under bankruptcy or other creditor’s rights laws that the transfer is a fraudulent
conveyance.
☐ Other: ___________________________________________
46. Commission. No real estate commissions or any other commissions shall be paid in connection with
this transaction.
47. Taxes. Seller shall be responsible for the payment of taxes, insurance, assessments, and any other
charges against the Premises up to the Closing Date.
48. Existing Mortgage. Seller, as a condition of the settlement of the Option to Purchase, shall not
possess a mortgage on the Premises in an amount greater than the Purchase Price or other
consideration as agreed to between the Seller and Buyer.
49. Option to Purchase Controlling. In the event a conflict arises between the terms and conditions of
this Agreement regarding the lease and the terms and conditions of this Agreement regarding the Option
to Purchase Agreement, the terms and conditions regarding the Option to Purchase shall control.
50. Purchase Default. In the event Buyer defaults after exercising the Option to Purchase, Buyer shall
forfeit ( ☐ the Deposit and) the credit, if any, Buyer would have received if Buyer closed on the Premises
to Seller as liquidated damages, which shall be the sole and exclusive remedy available to Seller. In the
event Seller defaults after Buyer has exercised the Option to Purchase, (☐ the Deposit and) the credit, if
any, Buyer would have received if Buyer closed on the Premises shall be refunded to Buyer, and Buyer
may sue for all remedies available at law or in equity.
51. No Equitable Ownership. It is understood by and between the parties hereto that no monthly rent
payment made under this Agreement shall allow or establish any equitable ownership interest in the
Premises by the Tenant.
52. Notices. Any notice required or permitted under this Agreement must be in writing. A notice is
effective upon receipt and shall be delivered in person, sent by overnight courier service or sent via
certified or registered mail, addressed to Landlord or Tenant at the address stated above or to another
address that either Party may designate upon reasonable notice to the other Party.
53. Severability. If any provision of this Agreement or the application thereof shall, for any reason and to
any extent, be invalid or unenforceable, neither the remainder of this Agreement nor the application of the
provision to other persons, entities or circumstances shall be affected thereby, but instead shall be
enforced to the maximum extent permitted by law.
54. Binding Effect. The covenants, obligations and conditions herein contained shall be binding on and
inure to the benefit of the heirs, legal representatives, and assigns of the parties hereto.
55. Headings. The descriptive headings used herein are for convenience of reference only and they are
not intended to have any effect whatsoever in determining the rights or obligations of the Landlord or
Tenant.
56. No Waiver. No indulgence, waiver, election or non-election by Landlord under this Agreement shall
affect Tenant's duties and liabilities hereunder.
57. Amendments. The parties hereby agree that this document contains the entire agreement between
the parties and this Agreement shall not be modified, changed, altered or amended in any way except
through a written amendment signed by all of the parties hereto.
58. Governing Law. This Option to Purchase Agreement shall be governed, construed and interpreted
by, through and under the Laws of the State of _________________.
59. Disputes. Any dispute arising from this Agreement shall be resolved through: (Check one)
☐ Court litigation. Disputes shall be resolved in the courts of the State of __________.
☐ Should it become necessary for Landlord to employ an attorney to enforce any of the
conditions or covenants hereof, including the collection of rentals or gaining possession of the
Premises, Tenant agrees to pay all expenses so incurred, including a reasonable attorneys' fee.
☐ Binding arbitration. Binding arbitration shall be conducted in accordance with the rules of the
American Arbitration Association.
☐ Mediation.
☐ Mediation, then binding arbitration. If the dispute cannot be resolved through mediation, then the
dispute will be resolved through binding arbitration conducted in accordance with the rules of the
American Arbitration Association
60. Entire Agreement. This document sets forth the entire agreement and understanding between the
parties relating to the subject matter herein and supersedes all prior discussions between the parties. No
modification of or amendment to this Option to Purchase Agreement, nor any waiver of any rights under
this Option to Purchase Agreement, will be effective unless in writing signed by the party to be charged.
Housing built before 1978 may contain lead-based paint. Lead from paint, paint chips, and dust can pose
health hazards if not managed properly. Lead exposure is especially harmful to young children and
pregnant women. Before renting pre-1978 housing, lessors must disclose the presence of known lead-
based paint and/or lead-based paint hazards in the dwelling. Tenants must also receive a federally
approved pamphlet on lead poisoning prevention.
Landlord’s Disclosure
(a) Presence of lead-based paint and/or lead-based paint hazards (check (i) or (ii) below):
(i) ____ Known lead-based paint and/or lead-based paint hazards are present in the housing
(explain): _________________________________________________________________________
(ii) ____ Lessor has no knowledge of lead-based paint and/or lead-based paint hazards in the
housing.
(b) Records and reports available to the lessor (check (i) or (ii) below):
(i) ____ Lessor has provided the lessee with all available records and reports pertaining to lead-
based paint and/or lead-based paint hazards in the housing (list documents below): ______________
_________________________________________________________________________________
(ii) ____ Lessor has no reports or records pertaining to lead-based paint and/or lead-based paint
hazards in the housing.
Tenant’s Acknowledgment(initial)
(c) ________ Tenant has received copies of all information listed above.
(d) ________ Tenant has received the pamphlet Protect Your Family from Lead in Your Home.
(e) ________ Agent has informed the landlord of the landlord’s obligations under 42 U.S.C. 4852d and is
aware of his/her responsibility to ensure compliance.
Certification of Accuracy
The following parties have reviewed the information above and certify, to the best of their knowledge,
that the information they have provided is true and accurate.
Complete this inventory checklist as soon as you sign the lease. Do not move anything into the Premises
until after you have filled out this checklist. Take time-stamped pictures of any damages, dents, marks, or
problems you find. Ask your Landlord to sign the checklist and/or send them a copy. You should keep the
original for your records.
Move in:
The following rules and regulations shall govern Tenant’s use and enjoyment of the Premises: (Check all
that apply)
☐ Tenant will not obstruct the driveways, sidewalks, courts, entry ways, stairs and/or halls.
☐ Tenant will keep all windows, glass, window coverings, doors, locks and hardware in good, clean
order and repair.
☐ Tenant will not leave windows or doors in an open position during any inclement weather.
☐ Tenant will not hang any laundry, clothing, sheets, etc. from any window, rail, porch or balcony nor
air or dry any of same within any yard area or space.
☐ Tenant will not cause or permit any locks or hooks to be placed upon any door or window without
the prior written consent of Landlord.
☐ Tenant will keep all air conditioning filters clean and free from dirt.
☐ Tenant will keep all bathrooms, sinks, toilets, and other water and plumbing supplies in good order
and repair, and shall use same only for the purposes for which they were constructed.
☐ Tenant will not allow any sweepings, rubbish, sand, rags, ashes or other substances to be thrown
or deposited into any sinks or toilets.
☐ Tenant's family and guests shall not make or permit any loud or improper noises, or otherwise
disturb other residents in the immediate area.
☐ Tenant will deposit all trash, garbage, rubbish or refuse in the locations provided therefore.
☐ Tenant will abide by and be bound by any and all rules and regulations affecting the Premises or
the common areas of the Premises which may be adopted or promulgated from time to time by
Landlord.
Other: ___________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________