Rent Payment Agreement Template

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Rent Payment Agreement
Date _________________
Tenant name(s)
_______________________________________________________________
Address of unit
_______________________________________________________________
_____________________________________________________________________ (tenants)
and ________________________________ (landlord) do hereby agree to enter into a rent
payment schedule for the tenant to pay in full a delinquent rent balance. The landlord agrees
not to take any eviction action, including the serving of termination notice or filing of eviction
action in court, as long as the tenant complies with this payment plan. Failure to make any
payment by any amount is considered a material violation of the rental agreement and failure
to remedy any notice already received, and is grounds for further action as permitted by law.
Both parties have a copy of this agreement.
Total amount to be paid: $ _________________
This amount includes rent as follows:
____________________________________________
____________________________________________
____________________________________________
Other charges as follows:
____________________________________________
____________________________________________
____________________________________________
Date Due
New Amount Due
To be Applied to
Balance Owed
1. __/__/__
___________________
___________________
___________________
2. __/__/__
___________________
___________________
___________________
3. __/__/__
___________________
___________________
___________________
4. __/__/__
___________________
___________________
___________________
5. __/__/__
___________________
___________________
___________________
6. __/__/__
___________________
___________________
___________________
7. __/__/__
___________________
___________________
___________________
Tenant Signature(s) ______________________________
Date _________________
______________________________
Date _________________
______________________________
Date _________________
Landlord Signature ______________________________
Date _________________
Tenant Resource Center, Inc. • (608) 257-0006/(877) 238-RENT (7368)
9/05

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