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FORM #46 - Assistance Animal Agreement


  • Tenant(s):
  • Tenant(s):
  • Address: Unit:
  • City: , OREGON Zip:

  • Type/Breed Name
  • Size Age Weight Color
  • Spayed/Neutered: __ Yes __ No Vaccinations: __ Yes __ No Photograph(s) attached: ___ Yes ___ No
  • License Number:

The Owner/Agent grants to the Tenant permission to keep the above listed animal at the premises subject to the following terms and conditions:

  1. Animal(s) shall be on a leash when it is outside the Tenant's dwelling unit.
  2. Tenant shall be liable for any damages caused by the animal(s), and Tenant shall be liable if animal(s) threaten to inflict or actually inflict substantial personal injury upon someone on the premises.
  3. Failure to comply with the terms of this agreement shall give the Owner/Agent the right to revoke permission to keep the animal.
  4. Animal(s) shall not cause any sort of nuisance or disturbance to the residents or neighbors. Resident will immediately report to Owner/Agent any damage by animal to persons or property. Resident(s) represent and warrant that the animal has not previously damaged persons or property.
  5. Per ORS 90.302, if Resident's animal defecates on any portion of the premises, Resident agrees immediately to remove the waste. After issuance of a written warning notice, Owner/Agent may assess a fee of $50.00 per occurrence, and $50.00 plus 5% of the rent amount for all subsequent offenses within one year of the original written warning notice.
  6. No animal waste including cat litter box waste may be flushed down toilets.
  7. Tenant(s) may not replace animal without written permission of Owner/Agent.
  8. This agreement becomes part of the Rental Agreement executed between the parties.
  9. Tenant(s) may not replace animal without written permission of Owner/Agent.
  10. This agreement becomes part of the Rental Agreement executed between the parties.

Responsible Party Certification: If the health or safety of the animal(s) is threatened by death, incapacity, or other factors that render the Resident unable or unwilling to care for the animal(s), the below-named party agrees to remove the animal(s) from the premises, either temporarily or permanently.

  • Name:
  • Address: Phone:

     

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1462 Commercial St. NE, Salem, OR 97301
Phone: 503-364-5468 | Fax: 503-585-8119

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