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FORM 2B - Fixed Term Agreement

Tenant, Address & Tenant Contact Info

  • Tenant(s):
  • Tenant(s):
  • Rented Premises: Unit:
  • City: , OREGON Zip:
  • Phone:
  • Cell or Mobile: Alternate Phone:
  • Email: Email:
  • Alternate Mailing:

Rent Amount, Due Date & Lease Term

  • Monthly Rent Amount: $ Due Date:
    Rent is payable on the 1st day of the month if left blank
  • Lease Term Beginning: Ending:
    1st month's prorated rent from to is $

Late Fees

If payment is not received by 11:59 pm on the 4th day of the rental period Tenant(s) will be charged as follows (select ONLY one):
___ One charge per rental installment limited to amount customary in rental area.
___ Per-day late fee shall not exceed 6% of the amount customary in rental area.
___ Incremental late fee shall not exceed 5% of monthly rent for each 5 days of delinquency or portion thereof.

Move-in Accounting Rent & Deposits

Security Deposit: $
Pet Deposit: $
Other Deposits: $
Pro-rated Rent: $
1st Full Month's Rent: $
Last Month's Rent: $
Other $
Minus Deposit to Hold: $
TOTAL Due: $

Non Compliance & Other Fees

Smoke Alarm and Carbon Monoxide Alarm tampering fee $250.00
Dishonored check fee (plus amount charged by bank) $ 35.00
Late payment of utility fee $ 50.00*
Failure to clean up animal waste, garbage or other waste $ 50.00*
Parking violation or other improper use of vehicle $ 50.00*
Smoking/Vaping in a clearly designated non-smoking unit or area $ 250.00*
Unauthorized pet capable of causing damage $ 250.00*
Early termination of lease fee $ (may not exceed 1 1/2 times monthly rent)
If left blank fee is 1 1/2 times the monthly rent.


Tenant shall mow, water and maintain lawn and landscaping in like manner in which it was received, unless otherwise indicated in writing.

O = Owner Pays T = Tenant Pays

___ Electricity ___ Water
___ Cable ___ Sewer
___ Gas ___ Garbage
Other _______________

Furnished to Unit

___ Electricity ___ Disposal ___ Blinds
___ Dishwasher ___ Refrigerator
___ Garbage Can ___ Dumpster
Other ____________________

Medical Marijuana

No marijuana, medical or otherwise, may be grown, stored or consumed on the premises without the prior written consent of Owner/Agent.

Occupancy of Premises

  • Only the following person(s) shall occupy the property:

Payments to Owner/Agent

  • Owner/Agent:
  • Address:
  • City/State/Zip:
  • Phone:
  • Email:

For Services of Notices to Owner/Agent

  • Same ____
  • Address:
  • City/State/Zip:

Emergency Contact

  • Person to notify in case of emergency or death of Tenant: (See # 12 page 3)
  • Name:
  • Relationship:
  • Address:
  • City: , State: Zip:
  • Phone: Email:

Utility or Service Charge Disclosure

Utility benefiting other Tenants or common area: __________________
Basis for allocation of utility or service charge for common areas:
Square footage by number of units or $ per


Parking Space(s)
Storage Space
Mailbox #

Pets Allowed

No ____ Yes ____
If yes, see attached Pet Agreement


  1. Recycling ___ IS ___ IS NOT available
  2. ___ If checked, Smoking is restricted/prohibited on the premises (See attached Smoke Free Agreement.)
  3. ___ If checked, the dwelling unit is located in a 100-year flood plain, as determined by the National Flood Insurance Program.
  4. ___ If checked, the unit is listed for sale.
  5. ___ If checked, the unit is in foreclosure or default.
  6. ___ If checked, Owner/Agent may enter the exterior of the premises at any reasonable time for landscaping and/or maintenance.
  7. Other:


© 2018 Oregon Rental Housing Association - All Rights Reserved
1462 Commercial St. NE, Salem, OR 97301
Phone: 503-364-5468 | Fax: 503-585-8119

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