Roommate Agreement Form Page 2
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28. Parties/Entertaining:
_______________________________________________________________________________
_______________________________________________________________________________.
9. Utility and Telephone Charges. Each roommate agrees to pay _______% of the utility charges:
/gas / electricity /water/. Each roommate will pay _______% of the monthly telephone service
charges and will pay for all of those telephone charges for which s/he is directly and individually
responsible.
Gas: Deposit in the amount of $__________ paid by ________________; each roommates’ share of the
monthly charge shall be paid to __________ ______________.
Electricity: Deposit in the amount of $__________ paid by _____________________________; each
roommates’ share of the monthly charge shall be paid to _________________________.
Water: Deposit in the amount of $__________ paid by ________________; each roommates’
share of the monthly charge shall be paid to _________________________.
Cable/Internet: Deposit in the amount of $__________ paid by __________________________; each
roommates’ share of the monthly charge shall be paid to_________________________.
Telephone/Internet: Deposit in the amount of $__________ paid by ______________________; each
roommates’ share of the monthly charge shall be paid to_________________________.
10. Household Chores. The Roommates will divide all household chores as follows:
_______________________________________________________________________________
_______________________________________________________________________________.
11. Cleanliness:
_______________________________________________________________________________
_______________________________________________________________________________.
12. Pets:
_______________________________________________________________________________
_______________________________________________________________________________.
13. Noise Level. During the hours of ___________, the Roommates will maintain a noise level that
will permit all of the Roommates to study.
14. Smoking. Smoking /is /is not /allowed in the Apartment.
15. Alcohol. Alcohol /is /is not/ allowed in the Apartment.
16. Parking. The Roommates agree that the parking space(s) located at___________________ shall be divided
as follows: __________________________________________________. The cost of the parking space(s) shall
be divided as follows: ___________________________________.
17. Additional Remarks (attach additional sheets if necessary to address other items such as security,
furniture, appliances, etc.)
_______________________________________________________________________________
_______________________________________________________________________________
18. Agreement is Complete and Binding. All preliminary negotiations by the Roommates are merged
into, and superseded by, the terms of the Agreement. Any modification to this Agreement must
be in writing, signed by all the Roommates.
We, the Undersigned, agree to the above stated terms.
Date: _______________ ______________________________
Date: _______________ ______________________________
Date: _______________ ______________________________
Date: _______________ ______________________________
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