Sample Partial Rent Payment Receipt printable pdf download

WASHINGTON

P RTI L RENT P YMENT RECEIPT

D TE

PROPERTY N ME / NUMBER

__________________________________________

___________________________________________________________________________________________________________________________________________________________________

RESIDENT N ME(S)

___________________________________________________________________________

and all others.

UNIT NUMBER

STREET DDRESS

___________________________________

___________________________________________________________________________________________________________________________________________________________________________

CITY

ST TE

ZIP

___________________________________________________________________________________________________________________________________________________

___________________________________

_____________________________________________________________

Resident understands that Owner/Agent is not required to accept late or partial payments of rent. Resident has asked Owner/Agent

to accept a partial payment along with Resident’s agreement to pay the balance due. Owner/Agent is willing to do so as an

accommodation to Resident. Resident understands that accepting the partial payment and the payment agreement does not

waive any of Owner/Agent’s rights to terminate Resident’s tenancy if payments are not made as agreed.

SAMPLE

Rent amount due:

_______________________________

SAMPLE

Partial payment received:

)

_______________________________

SAMPLE

Rent balance due:

_______________________________

SAMPLE

Late fees:

_______________________________

SAMPLE

Other:

____________________________________________________

_______________________________

SAMPLE

Balance due:

_______________________________

Resident agrees to pay the balance due as follows:

DUE DATE

AMOUNT

SAMPLE

______________________________________

_______________________________

SAMPLE

______________________________________

_______________________________

SAMPLE

______________________________________

_______________________________

All payments must be received by Owner/Agent by 5:00 p.m. on each due date, time being of the essence. All payments must

be made by money order or cashier’s check.

If Owner/Agent has previously issued a termination notice for non-payment of rent (3-Day Notice to Pay or Vacate),

acceptance of this partial rent payment does not waive Owner/Agent’s right to terminate if Resident fails to pay the

balance at the time set forth above. No new termination notice need be given if Resident fails to pay the balance at the

time set forth above. Owner/Agent may commence proceedings for non-payment of rent if subsequent payments are not

made on or before the stated date.

The signature of any one Resident to this agreement binds all Residents of the unit.

_____________________________________________________________________________________

_____________________________

_____________________________________________________________________________________

_____________________________

OWNER/AGENT

DATE

RESIDENT

DATE

SAMPLE

_____________________________________________________________________________________

_____________________________

______________________________________________________________________________________________________________________

RESIDENT

DATE

ADDRESS

SAMPLE

_____________________________________________________________________________________

_____________________________

______________________________________________________________________________________________________________________

RESIDENT

DATE

SAMPLE

______________________________________________________________________________________________________________________

_____________________________________________________________________________________

_____________________________

RESIDENT

DATE

TELEPHONE

ON SITE

RESIDENT

M IN OFFICE (IF REQUIRED)

Sample Partial Rent Payment Receipt

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