Short Term Vacation Rental Application - Sample Rental Agreement

Ski Lease Rental Application - Sample 2016-17 Ski Lease


This Application is made to lease the vacation rental at:

?830 Ward Creek Blvd
Tahoe City, CA 96145

Desired date of occupancy:_______________________________________
Desired length of occupancy:______________________________________


Name of Primary Applicant: ____________________________________________________________________
Home Address: _________________________________________________________Rent:_____Own:_______
Home Phone No.: (____)_______________
Cell Phone No.: (_____)________________
Email Address: ________________________________________________
Driver's License No. :__________________
Business Phone: (____)____________    

Total number of proposed occupants:             Adults: _____ Children: _____ (list age after name)
Names of all secondary tenants:   
____________________________________            ______________________________________
____________________________________            ______________________________________
____________________________________            ______________________________________
____________________________________            ______________________________________
____________________________________            ______________________________________
____________________________________            ______________________________________                                                      

Smokers:                     No _____        Yes _____
Pets:                            No _____        Yes _____:  number____type_____breed_______________gender____

I represent that the information provided in this Application is true and correct to the best of my knowledge. 

_____________________________________________     ____________________
Primary Applicant's Signature                                                    Date




(list all occupants)_______________________________________________________________________________
Phone-Home: ___________________________Cell: ____________________________________
Email Address: __________________________________________________________________ 

Booking Confirmation
Dear : 
Thank you for choosing our home for your vacation. We hope that you have a pleasant stay.
The house is located at:     830 Ward Creek Blvd ,Tahoe City, CA 96145
Your confirmation is as follows:
Check-in date: 00/00/2015 after 4PM PDT (No early check-in please)
Check-out date: 00/00/2015 by 10AM PDT (No late checkout please)
Number of adults: _____ Number of children: ______ (age(s)______________ ____)
Pets? Y / N   Number: _______Type:_________Gender:_____Breed: ___________________
Smokers?   Yes _____ No ________
DL# _____________________ 

Your bill and payment schedule are as follows:
Security Deposit                               $   300.00
CSA Damage Protection Ins               $     59.00         
Rental Rate                                       $   000.00
Cleaning Fee                                     $   235.00
Pet Fee(if applicable $75)                $     00.00
Taxes (10%)                                      $     00.00
Service Fee (VRBO bookings only)    
$     00.00
Total Rental Payment DUE:              $ 0000.00

Payment Schedule:
1st Payment, due upon receipt             $ 0000.00
2nd Payment, due 00/00/2015             $ 0000.00 (45 days prior to reservation)
Total Payments:                                    $ 0000.00

Payment Methods Accepted:
Direct deposit made to Leslie Matarazzo's Bank of America or US Bank Account (# w/b provided)
Personal checks made payable to Leslie Matarazzo provides all other payment methods, including e-check, Paypal, Visa, MasterCard, Discover (credit cards: 2.9% convenience fee will applies which will be assessed to tenant) 

Please sign and return the rental rules outlined below. After I have received your final payment, you will be sent the Keyless Entry combination and "operating instructions" for the property. Please call or email any questions. 

Thanks, and have a great vacation!

Sandy MatarazzoLeslie (Sandy) Matarazzo - 623-203-9123/530-583-4308

Rental Rules 

ADDRESS: 830 Ward Creek Blvd
                   Tahoe City, CA 96145
                   Phone: 530-583-4308 

CHECK-IN TIME is AFTER 4 PM PDT AND CHECKOUT is 10 AM PDT. NO Early Check-in or late checkout. 

MAXIMUM OCCUPANCY – The maximum number of guests is limited to ________ persons. An additional charge of $75.00 per person per night for guests in addition to __________ will be assessed. 

This house is insured as a NON SMOKING unit. No smoking is permitted anywhere on the premises. 

UNLAWFUL ACTIVITIES - No guest shall engage in unlawful activities on any part of the premises. 

FACILITIES USAGE - The house is completely available for your enjoyment with the following exceptions: there are two (2) clothes closets, four (4) china cabinet compartments and two (2) livingroom cabinets which have been locked to secure the owners' private property and are labeled. The outbuilding at the back of the property is also locked to secure private property and is not available for Tenant use.

PETS - PETS are not permitted without prior written authorization. 

DAMAGE/RESERVATION DEPOSIT - A reservation deposit of $300 is required. The deposit automatically converts to a security/damage deposit upon arrival. The deposit is NOT applied toward rent; however, it is fully refundable within (14) days of departure, provided the following provisions are met.

  • No damage is done to unit or its contents, beyond normal wear and tear.
  • No charges are incurred due to contraband, pets, collection of rents or services rendered during the stay.
  • All debris, rubbish and discards are placed in dumpster, and soiled dishes are placed in the dishwasher and cleaned.
  • All keys are left on the kitchen table and unit is left locked.
  • All charges accrued during the stay are paid prior to departure.
  • No linens are lost or damaged.
  • No early check-in or late checkout.
  • Predator Repellent Electrical Fencing is activated at night and during any time the property is vacant.
  • The renter is not evicted by the owner (or representative of the owner), or local law enforcement. 

NO DAILY HOUSEKEEPING SERVICE – While linens and bath towels are included in the unit, daily maid service is not included in the rental rate. Laundry facilities are provided for daily care, if needed. We suggest you bring beach towels. The beach towels provided are for use with the Hot Tub. We do not permit towels or linens to be taken from the unit. You will be charged for missing towels. 

PARKING – PARKING – Parking is limited to six (6) vehicles.  Vehicles are to be parked in designated parking areas only.  Parking on the road is not permitted.  Any illegally parked cars are subject to towing; applicable fines/towing fees are the sole responsibility of the vehicle owner. 

HOT TUB – No children under the age of 12 permitted in hot tubs at any time.  When using the hot tub, remember there is a certain health risk associated with this facility. Use at your own risk.  Our spa maintenance personnel drain, sanitize, refill and replenish chemicals in the tub prior to your arrival. DO NOT STAND ON THE HOT TUB COVERS, which are for insulation purposes and are not designed to support a person or persons. They will break and you may be charged for replacement. When removing the cover, please place it to the side of the tub not enclosed to avoid damage to the wood lattice (the cover is fairly heavy). The hot tub shall be covered and locked for safety of children and from "poachers" and to maintain temperature whenever the tub is not in use. 

FIREPLACES – The fireplace is wood burning. Never leave a fire unattended or the screen open. Firewood in garage is for ski-lease only.

BARBEQUE - The Barbeque is propane. Please follow directions and use care when lighting the Barbeque. Do not leave the Barbeque unattended. Turn off the propane tank when not in use. 

WATER AND SEWER – These homes are on a well. The water is quite cold and may take a while to heat. The homes are on City Sewer, but DO NOT FLUSH anything other than toilet paper. No feminine products should be flushed at anytime. If it is found that feminine products have been flushed and clog the sewer system, you could be charged damages. 

PAYMENT – An advance payment equal to approximately 50% of the rental cost, which includes a Damage Insurance fee (or comparable deposit) and deposit (as previously described), is required within 5 days of booking. Please make payments via direct deposit, personal check or credit card (fee applies) payable to Richard or Leslie Matarazzo. The BALANCE OF RENT is due forty-five days before your arrival date. Payments made more than five (5) days after the due date may incur a $25 late fee. Returned checks incur a $35 fee.

CANCELLATIONS –Cancellations that are made more than sixty (60) days prior to the arrival date are subject to a cancellation fee of $100.  Cancellations or changes that result in a shortened stay, that are made less than 60 days prior to the arrival date, forfeit the full advance payment and reservation deposit. Cancellation or early departure does not warrant any refund of rent. 

STORM POLICY– STORM POLICY/ROAD CONDITIONS – No refunds will be given for storms. Mountain roads can be curvy and steep. Roads and driveways are well maintained; however, we highly recommend four wheel drive and/or chains during the snow months. We do not refund due to road or weather conditions. 

TRAVEL INSURANCE – We highly recommend all guests purchase travel insurance. If you wish to purchase travel insurance, go to details and to purchase. VRBO purchases a $1500 insurance policy for you to cover damages exceeding the Security Deposit. 

INCLUSIVE FEES – Rates include a one-time linen & towel setup. Amenity and utility fees are included in the rental rate. 

RATE CHANGES – Once confirmed, rates are not subject to change without notice.

FALSIFIED RESERVATIONS – Any reservation obtained under false pretense will be subject to forfeiture of advance payment, deposit and/or rental money, and the party will not be permitted to check in. 

WRITTEN EXCEPTIONS – Any exceptions to the above mentioned policies must be approved in writing in advance. 

The Homeowners are not responsible for any accidents, injuries or illness that occurs while on the premises or its facilities. The Homeowners are not responsible for the loss of personal belongings or valuables of the guest (we will make an effort to return them to you if we find them). By accepting this reservation, it is agreed that all guests are expressly assuming the risk of any harm arising from their use of the premises or others whom they invite to use the premise. 

Acceptance of Reservation and Rental Rules: ______________________________________                                                                                                            (signed) (Tenant)


This Application is made to lease the vacation rental at:

830 Ward Creek Blvd
Tahoe City, CA 96145

for a term of 4 to 5 months for vacation use only - not to be occupied as a full-time residence.
Desired date of occupancy:_______________________________________
Desired length of occupancy:______________________________________

The Applicant understands that the Landlord may perform a credit check to verify the Applicant's credit references and credit history in connection with the processing of this Rental Application.


Name of Primary Applicant: ____________________________________________________________
Home Address: _____________________________________________________________Rent:_______Own:_______
Home Phone No.: (____)__________________
Cell Phone No.: (_____)________________
Email Address: ________________________________________________
Social Security No.: _______-______-_______Driver's License No. :______________________
Vehicle Model: _____________________Year: __________License No.: ________________________
Employer:  _____________________________________________________________
Address:  ___________________________________________________________________________
Business Phone: (____)____________  Position: _________________________  
Prior Ski Lease Address: ______________________________________________________________
 Contact Name and Phone/Email: _______________________________________________________

Total number of proposed occupants:             Adults: _____ Children: _____
Names of all secondary tenants:       

1.____________________________________         7.______________________________________
2.____________________________________         8.______________________________________
3.____________________________________         9.______________________________________
4.____________________________________         10._____________________________________
5.____________________________________         11._____________________________________
6.____________________________________         12._____________________________________                                                

Smokers:                     No _____        Yes _____
Pets:                            No _____        Yes _____:  number____type_____breed___________gender____

I represent that the information provided in this Application is true and correct to the best of my knowledge. 
RICHARD OR LESLIE MATARAZZO is authorized to verify the references and employment information given in this
Application and to request a credit check. 

_____________________________________________     ____________________
Primary Applicant's Signature                                               Date

Sample 2016-17 Ski Lease


A. Richard and Leslie Matarazzo, Landlord, rents to Tenant and Tenant rents from Landlord, the real property and improvements described as 830 Ward Creek Blvd, Tahoe City, CA 96145 ("Premises").
B. The Premises are for the sole use as a vacation residence by the following named persons only:
(Names) and his/her authorized guests only (listed on Lease Application), not to exceed ten persons at any one time.
C. The following personal property, maintained pursuant to paragraph 11, is included:
a complete and current inventory list will be provided prior to occupancy.

2. TERM: The Lease Term begins on _______________ ("Commencement Date") at 5:00 PM and shall terminate on ____________at 5:00 PM. Tenant shall vacate the Premises upon termination of each Term, unless Landlord and Tenant extend this agreement in writing.

3. RENT: "Rent" shall mean all monetary obligations of Tenant to Landlord under the terms of the Lease agreement, except Security Deposit.
A. Tenant agrees to pay $3,000.00/month for the term of the Lease Agreement.
B. Rent is payable in advance 30 days prior to occupancy as detailed in Section 5.
C. PAYMENT: Rent shall be paid by direct deposit to: Richard or Leslie Matarazzo, Bank of America Account #_____________.

A. Tenant agrees to pay $2,500.00 as a security deposit, due upon signing of the Lease. Security Deposit will be held by the Landlord in a non-interest bearing account.
B. All or any portion of the security deposit may be used, as reasonably necessary, to: (1) cure default in payment of Rent (which includes Late Charges, NSF fees or other sums due); (2) repair damage, excluding normal wear and tear, caused by Tenant or by a guest or licensee of Tenant; (3) clean Premises, if necessary, upon termination of the tenancy; and 4) replace or return personal property or appurtenances. Within 21 days after Tenant vacates the Premises and Lease Agreement terminates, Landlord shall: (1) furnish Tenant an itemized statement indicating the amount of any security deposit retained and the basis for its disposition and supporting documentation as required by California Civil Code 1950.5(g); and (2) return any remaining portion of the security deposit to Tenant.
C. Security deposit will not be returned until all Tenants have vacated the Premises and all keys returned. Security deposits returned by check shall be made out to Tenants named on this Agreement.

5. MOVE-IN COSTS RECEIVED/DUE: Move-in funds made payable to: Richard or Leslie Matarazzo shall be paid by: personal check OR direct deposit to Bank of America Account #_____________.

Category                                                 Total Due               Payment Received             Balance Due                         Date Due
Rent from 12/04/2015 to 5/3/2016        $15,000.00                                                        $15,000.00                           10/30/2016
Security Deposit                                     $ 2,500.00                                                            2,500.00                           Execution
CSA Damage Insurance $3,000 limit         $      79.00                                                                79.00                           Execution
Other: Deposit for estimated Tenant
utilities paid by Landlord during lease term:
Cable TV($315), Internet($210),Phone($50)
Spa Service ($550),Snow Plowing ($650)   $  1,775.00                                                           1,775.00                            Execution
Total                                                      $19,354.00                                                        $ 19,354.00

A. Tenant acknowledges either late payment of Rent or issuance of a returned check may cause Landlord to incur costs and expenses, including processing, enforcement, accounting expenses and late charges imposed on Landlord. If any installment due from Tenant is not received by Landlord within 5 calendar days after the due date, or if a check is returned, Tenant shall pay to Landlord an additional sum of $50.00 as a late charge and $35 NSF fee.
B. Landlord and Tenant agree that these charges represent a fair and reasonable estimate of the costs Landlord may incur by reason of a late or NSF payment.

Parking is permitted as follows: in the Premises' driveway, parking areas or garage only. You will be ticketed or towed if parked on the street during winter months, November 1st to May 1st. Parking for 1 car in garage; other garage space is used as a mud room and entrance to the house. Vehicles leaking oil or other fluids may not be parked on the driveway or in the garage, but may park on the gravel parking area.

8. STORAGE: Storage is permitted as follows: in house or garage only.

9. UTILITIES: Tenant agrees to pay for the following utilities and charges: Cable TV, Internet, Telephone, Firewood, Spa Maintenance Service, Driveway Snow Plow, Gas and Electric. Cable, Internet, Telephone, Snow Plowing and Spa Service will remain in the Landlord's name. Gas and Electric will be transferred into Tenant's name at the beginning of the Lease and back into the Landlord's name at the end of the Lease period. The transfer charges will be borne by the transferring party. Failure to transfer service in a timely manner incurs a penalty of $100. The Landlord agrees to pay for the following utilities and charges: water, sewer, garbage removal service, Netflix .

10. CONDITION OF PREMISES: Tenant has examined Premises and, if any, all furniture, furnishings, appliances, landscaping and fixtures, including smoke detectors. Move-in check list to be provided prior to occupancy.

A. Tenant shall properly use, operate and safeguard Premises, including, if applicable, any landscaping, furniture, furnishings and appliances and all mechanical, electrical, gas and plumbing fixtures, and keep them and the Premises clean, sanitary and well ventilated. Tenant shall be responsible for checking and maintaining all smoke detectors. Tenant shall immediately notify Landlord in the most expedient manner of any problem, malfunction or damage. Tenant shall be charged for all repairs or replacements caused by Tenant, pets, guests or licensees of Tenant, excluding ordinary wear and tear. Tenant shall be charged for all damage to Premises as a result of failure to report a problem in a timely manner.

12. NEIGHBORHOOD CONDITIONS: Tenant is advised to satisfy him or herself as to neighborhood or area conditions including, but not limited to, proximity of transportation, emergency services, noise, wild or domestic animals and other nuisances, hazards or circumstances.

13. PETS: No pets allowed without Landlord's prior written consent.

14. NO SMOKING. The Premises (including the house, garage and grounds) are insured as NON-SMOKING; therefore, absolutely no smoking can be allowed on the Premises. If smoking does occur on the Premises, (1) Tenant is responsible for all damage caused by the smoking including, but not limited to, stains, burns, odors and removal of debris; (2) Tenant is in breach of this Agreement; (3) Tenants, Authorized Guests, and all others may be required to leave the Premises; and (4) Tenant acknowledges that in order to remove odor caused by smoking, Landlord may need to replace carpet and drapes and paint entire Premises regardless of when these items were last cleaned or replaced. Such actions and other necessary steps will impact the return of any security deposit.

A. Tenant agrees to comply with all Landlord rules and regulations that are at any time posted on the Premises or delivered to Tenant. Tenant shall not, and shall ensure that guests and licensees of Tenant shall not, disturb, annoy, endanger or interfere with neighbors, or use the Premises for any unlawful purposes, including, but not limited to, using, manufacturing, selling, storing or transporting illicit drugs or other contraband, or violate any law or ordinance, or commit a waste/nuisance on/about Premises.

16. PUD: N/A

17. ALTERATIONS/REPAIRS: Tenant shall not make any repairs, alterations or improvements in or about the Premises without Landlord's prior written consent, including: painting, wallpapering, adding or changing locks, installing antenna or satellite dishes, placing signs, displays or exhibits, or using screws, fastening devices, nails or adhesive materials.

A. Tenant will receive prior to the Commencement Date: 
3 keys to Premises (1 each: front door, back garage door, connecting door from garage to house)
6 remote control devices for garage door
1 Code to keyless garage door opener installed on side of garage
B. Tenant acknowledges that locks to the Premises have not been re-keyed (except the Keyless Code).
C. If Tenant re-keys existing locks or opening devices, Tenant shall immediately deliver copies of all keys to Landlord. Tenant shall pay all costs and charges related to loss of any keys or opening devices. Tenant may not remove locks, even if installed by Tenant.

19. ENTRY:
A. Tenant shall make Premises available to Landlord or Landlord's representative for the purpose of entering to make necessary or agreed repairs, decorations, alterations or improvements, to supply necessary or agreed services, or periodic inspections.
B. Landlord and Tenant agree that 24-hour written notice shall be reasonable and sufficient notice, except as follows: 48-hour written notice is required to conduct an inspection of the Premises, unless the Tenant waives the right to such notice. No notice is required: (1) to enter in case of an emergency; (2) if the Tenant is present and consents at the time of entry; or (3) if the Tenant has abandoned or surrendered the Premises. No written notice is required if Landlord and Tenant orally agree to an entry for agreed services or repairs if the date and time of entry are within one week of the oral agreement.
C. Tenant authorizes the use of a Keyless Entry Pad to allow authorized entry into the Premises.

20. SIGNS: Tenant authorizes Landlord to place FOR LEASE signs on the Premises.

21. ASSIGNMENT; SUBLETTING: Tenant shall not sublet all or any part of Premises, or assign or transfer this Agreement or any interest in it, without Landlord's prior written consent. Unless such consent is obtained, any assignment, transfer or subletting of Premises or this Agreement or tenancy, by voluntary act of Tenant, operation of law or otherwise, shall, at the option of Landlord, terminate this Agreement.

22. JOINT AND INDIVIDUAL OBLIGATIONS: If there is more than one Tenant, each one shall be individually and completely responsible for the performance of all obligations of Tenant under this Agreement, jointly with every other Tenant, whether or not in possession.

23. LEAD BASED PAINT: Premises were construction prior to 1978. In accordance with federal law, Landlord gives and Tenant acknowledges receipt of the disclosures on the attached form and the federally approved Lead Pamphlet.




27. MEGAN'S LAW DATABASE DISCLOSURE: If Tenant desires information regarding the possible proximity of registered sex offenders, they should obtain this information directly from

A. Tenant is not in possession of the Premises. If Landlord is unable to deliver possession of the Premises on Commencement Date, such Date shall be extended to the date on which possession is made available to Tenant.

A. Upon termination of this Agreement, Tenant shall: (1) give Landlord all copies of keys or opening devices to Premises, including any common areas; (2) vacate and surrender Premises to Landlord, empty of all persons; (3) vacate any/all parking and/or storage space; (4) clean and deliver Premises to Landlord in the same clean, tidy and undamaged condition as received at the start of the lease; (5) remove all debris; and (6) arrange for house and carpets to be professionally cleaned upon departure in April (carpet cleaning arranged by Landlord and deducted from security deposit).
B. Any alterations or improvements made by Tenant become the property of Landlord.

30. BREACH OF CONTRACT; EARLY TERMINATION: In addition to any obligations established by paragraph 29, in the event of termination by Tenant prior to completion of the original term of the Agreement, Tenant shall also be responsible for lost Rent, rental commissions, advertising expenses and reconditioning costs necessary to ready Premises for re-rental. Landlord may withhold any such amounts form tenant's security deposit.

31. TEMPORARY RELOCATION (for fumigation): Not Applicable

32. DAMAGE TO PREMISES: If, by no fault of the Tenant, the Premises are totally or partially destroyed by fire, earthquake, accident or other casualty that render Premises inhabitable, either Landlord or Tenant may terminate this Agreement by giving the other written notice. Rent shall be abated as of the date Premises becomes uninhabitable.

33. INSURANCE: Tenant's or guest's personal property and vehicles are not insured by Landlord against loss or damage due to fire theft, vandalism, rain, water, criminal or negligent acts of others, or any other cause. Tenant is advised to obtain their own insurance coverage to protect Tenant from any such loss or damage.

34. WATERBEDS: Not Applicable - furnished home with no waterbeds

35. WAIVER: The waiver of any breach shall not be construed as a continuing waiver of the same or any subsequent breach.

36. NOTICE: Notices may be served at the following address, or at any other location subsequently designated:
Landlord: Richard or Leslie (Sandy) Matarazzo                                  Tenant: (Names- addendum will be added for additional names)
P.O. Box 7397                                                                                              (Street Address)
Tahoe City, CA 96145 (City, State, Zip Code)
_______________________ (email addresses, phone numbers)                       _______________________ (email addresses, phone numbers)


38. TENANT REPRESENTATIONS; CREDIT: Tenant warrants that all statements in Tenant's rental application are accurate. Landlord may cancel this Agreement upon discovering that information in Tenant's application is false.

39. MEDIATION: Not Applicable

40. ATTORNEY FEES: In any action or proceeding arising out of this Agreement, the prevailing party between Landlord and Tenant shall be entitled to reasonable attorney fees and costs.


42. ENTIRE CONTRACT; CHANGES: All understandings between the parties are incorporated in this Agreement and Addendum.

Tenant agrees to lease the Premises on the above terms and conditions:

_________________________________________                                 Date: ____________________________
(All named Tenants will sign on this page)

Landlord agrees to rent the Premises on the above terms and conditions:

_________________________________________                               ______________________________________
RICHARD MATARAZZO                                                                    LESLIE MATARAZZO

Date: ____________________________________                                   Date: _________________________________


The following terms and conditions are hereby incorporated in and made a part of the Residential Lease Agreement in which (Names) is referred to as "Tenant" and Richard and Leslie Matarazzo are referred to as "Landlord".

1. This Lease is not intended for full-time occupancy; it is for vacation use only.

2. Tenant is to maintain adequate heat in the Premises (55* minimum required by insurance company) to ensure protection of the water pipes. Thermostat Instructions are posted by the Thermostat and in the Inventory List.

3. Tenant and his guests acknowledge that they have received advisories and instructions for the Predator Repellant Fencing installed on the exterior of the doors and windows (attached) and are able to operate it in a safe and proper manner. Both system zones must be in operation at any time the property is not occupied. It is recommended that the system be on during sleeping hours.

4. There is a protective barrier outside the back door by the dining room table. This is to prevent damage to the windows when snow sheds from the roof. This protective barrier shall remain in place whenever the snow level on the back deck poses a potential threat of damage to the French doors.

5. Long Distance service is provided through Suddenlink and is included ; no access code is needed.

6. Restatement of Paragraph 14 for emphasis: NO SMOKING. The Premises (including the house, garage and grounds) are insured as NON-SMOKING; therefore, absolutely no smoking can be allowed on the Premises.

7. A Barbeque grill has not been provided, but should Tenants bring one to Premises, it may only be used outside of buildings and not under any walkways or eves; place provided oven liners under it to catch drips.

8. Furniture should not be moved; many pieces are antiques and may be damaged. If any small items are moved, like chairs or lamps, those should be replaced in their original locations prior to vacancy. All items should be returned to their original locations at vacancy.

9. Tenant shall keep a Renters Insurance Policy in force during his tenancy to insure against damage exceeding the Security Deposit.

The foregoing terms and conditions are hereby agreed to, and the undersigned acknowledge receipt of a copy of this document:

Date: __________________________________                              Date: ________________________________________

Tenant: __________________________________                           Landlord: _____________________________________
(All tenants will sign here)
                                                                                                    Landlord: _____________________________________



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