Lease Special Stipulations Form - Tenancy Addendum Section 8 Tenant-Based Assistance Housing Choice Voucher Program
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1LEASE SPECIAL STIPULATIONS:
6. Rent to Owner:
The initial rent to owner is _______________________ .
a. The initial rent to owner may not exceed the amount approved by
1. Contents of Lease:
the HA in accordance with HUD regulations.
The lease shall consist of the Tenancy Addendum Section 8 Tenant-
b. Changes in the rent to owner shall be determined by the
Based Assistance Housing Choice Voucher Program, the owner's
provisions of the lease. However, the owner may not raise
lease, and attached lease special stipulations. If there is any conflict
the rent during the initial term of the lease.
between the tenancy addendum/lease special stipulations and any
c. During the term of the lease (including the initial term of the
other provisions of the lease, the language of the tenancy
lease and any extension term), the rent to owner may at no time
addendum/lease special stipulations shall control.
exceed:
1)
The reasonable rent for the unit as most recently
2. Parties to Lease:
determined or redetermined by the HA in accordance with
Tenant ___________________________________________
HUD requirements, or
Owner ___________________________________________
2)
Rent charged by the owner for comparable unassisted units.
d. The owner will submit to the tenant for their consideration and
3. Unit Rented:
DCA for their review any new lease or lease revision – a minimum
This is a lease for the following dwelling unit:
of 60 days in advance of the effective date of the lease or the lease
Address __________________________________________
revision. The rent cannot be increased until after the initial term
Apartment ________________________________________
of the lease.
City ________________________ State ____ Zip_________
7. Utilities and Appliances:
The owner shall provide or pay for the utilities and appliances
4. Members of Household:
as indicated below by an “O” without any additional charge to
The following persons may reside in the unit. No other persons
the tenant. The tenant shall provide or pay for the utilities and
may reside in the unit without prior written approval by the
appliances as indicated below by a “T”.
owner and the HA.
_________________________________________________
ITEM
PROVIDED/PAID BY
_________________________________________________
_________________________________________________
Heating
Natural gas
____
_________________________________________________
Bottle gas
____
_________________________________________________
Oil/Electric
____
Coal/Other
____
5. Term of Lease:
Cooking
Natural gas
____
The initial lease term begins on
.
Bottle gas
____
The initial lease term ends on
.
Oil/Electric
____
After the initial lease term, the lease term shall renew in the
Coal/Other
____
following manner: (PLEASE INDICATE)
________a). year to year; or
Other Electric
____
________b). for an indefinite extension until the owner/tenant
submits notice of lease termination to each other
Air Conditioning
____
and the Housing Authority; or
________c). Other – please detail
Water Heating
Natural gas
____
_________________________________________________
Bottle gas
____
_________________________________________________
Oil/Electric
____
_________________________________________________
Coal/Other
____
The owner will provide the tenant and DCA with a 60 day notice
Water
____
(during the initial term) of his intent not to renew the lease at the
Sewer
____
expiration of the initial term of the lease. The tenant will provide the
Trash
____
owner and DCA with a ______day notice (during the initial term) of
Range/Microwave
____
his intent to move at the expiration of the initial term of the lease.
Refrigerator
____
Other (specify)
____
Following lease renewal, after the initial term, the owner will provide
8. Security Deposit:
the tenant and DCA with a __________day notice to terminate for
The security deposit is ______________________________.
other good cause. The tenant may terminate the lease without cause at
The tenant has paid the security deposit to the owner.
any time after the initial term if the tenant provides written
notification to the owner and DCA at least ______ days before the
OWNER:
termination.
TENANT:
_______________________________________________________
Print or Type Name of Owner
___________________________________________________
________________________________________________________
Print or Type Name of Tenant
Signature
________________________________________________________
___________________________________________________
Print or Type Name of Signatory
Signature
________________________________________________________
Date
___________________________________________________
Date
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