Community Room Rental Agreement Northwood Page 3

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APPROVED ON: ____________________________
______________________________________________
Date
City Employee
DEPOSIT RECEIVED AND RENTAL FEE PAID: __________________________
Date
KEY RETURNED: _______________________
DEPOSIT RETURNED: __________________________
Date
Date
Deposit not returned for the following reasons:
_____________________________________________________
________________________________________________________________________________________________
Attest:
_________________________________________________________________________________________
City Employee’s Signature/Title
Revised 9/12/11 DJH
*PLEASE SEE OTHER SIDE

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