Roommate Agreement Form

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ROOMMATE AGREEMENT
THIS AGREEMENT MADE THIS ____ DAY OF _______________, 20___,
BY AND BETWEEN:
1.____________________________________
4.____________________________________
2.____________________________________
5.____________________________________
3.____________________________________
6.____________________________________
WHEREAS, the parties hereto have on the ____ day of _____________________, 20___, signed a lease
for (address)__________________________________________________________ for a term lasting from
____________________________ to __________________________; (a copy of which is attached hereto), and
plan to reside on said premises as roommates; and,
WHEREAS, the said roommates wish to provide for the sharing of responsibilities in the renting of
said premises;
IT IS THEREFORE AGREED AS FOLLOWS:
1. Each of the roommates agrees to follow the rules and conditions set out in the attached lease and in
this Roommate Agreement.
2. Each of the roommates shall pay monthly rent as follows (fill in the specific dollar amount each
roommate is to pay per pay period):
a.___________________________________
d.____________________________________
b.___________________________________
e.____________________________________
c.___________________________________
f.____________________________________
3. The roommates shall pay an equal share (fill in percentage, i.e., 1/3, 1/4) ____, on a monthly basis,
of the following expenses incurred relating to the premises including (as applicable under the lease): electric,
gas, heat, basic telephone service, water, garbage pick-up and sewage, and (check if applies): cable__; food__;
cleaning and/or other contracted for services (specify)___________________________________________;
other_____________________________________________________________________________________.
4. Each roommate shall pay for the long distance telephone calls he or she makes.
5. Each roommate shall be solely responsible to pay promptly any fines, fees or other charges assessed
by the landlord for the said roommate's violation of the lease, including late payment of rent, bounced check
charges, pet clause violation, key replacement, illegal parties, etc., and shall hold the other roommates
harmless thereon.
6. Each roommate shall be solely responsible for intentional or accidental damages they or their
guests cause to the premises, including charges assessed by the landlord for the roommate's failure to remove
his or her property at the end of the lease, and shall hold the other roommates harmless thereon.
7. Each roommate agrees not to take or use, without consent, the personal property of any of the
other roommates, including food, clothes, utensils, jewelry, motor vehicles, T.V. and stereo, and the like.

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