Full Name:
Address:

Add another Landlord? No Yes

Full Name:
Current Address:

Would you like another tenant to sign this contract? No Yes

Bedrooms:	Leave out of agreement 0 1 2 3 4 5 6
Bathrooms:	1 0 1 2 3 4 5 6

Is there a minimum age for residents? No Yes

Specify the minimum age:

Specify number of residents allowed? No Yes

Maximum number of residents: 1 2 3 4 5 6

Smoking permitted in the House? Yes No

Free Parking Stalls	0 1 2 3 4 5
Paid Parking Stalls	0 1 2 3 4 5 for a total cost of

Provide a description of the parking:

The agreement will continue until termination      Number of days notice to terminate agreement: The agreement will have a fixed end date

This Lease will be based on a MonthlyWeekly Yearly term.

The Lease will start July January February March April May June July August September October November December 30 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2010 2005 2006 2007 2008 2009 2010 2011

Amount:
Form of Payment:	CheckCheck Cash Money Order Cashier's Check Electronic Deposit
Rent to be paid:	MonthlyBi-Weekly Monthly Annually
Payment is due:
Address for Payment:	Same as Landlord's? Yes No

Gym Swimming Pool Tennis Courts Central Vacuum System	Sauna Hot Tub Tanning Bed Garbage Removal
Other:

Power/Electricity Heating Gas Phone	Cable T.V. High Speed Internet Satellite Security System
Other:

Microwave Stove Dishwasher Washing Machine Humidifier	Dryer Refrigerator Air-Conditioning Garborator Trash Compactor
Other:

Sofa Dinning Room Set with chairs. Coffee Table End table Lamps Drapes/Curtains/Blinds Bed Other

Landscaping Snow Removal Carpet Cleaning Other

Agreement Signing Date: July January February March April May June July August September October November December 30 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2010 2005 2006 2007 2008 2009 2010 2011 Leave Date Blank

Would you like to add an additional paragraph? No Yes