Complete Your Custom ORHA Rental Form

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Tenant, Address & Tenant Contact Info



Due on: Monday of each week.

Week-to-Week Tenancy beginning:

1st weeks' Rent pro-rated

and exclusion from the following spaces:
All other areas of the property and unit, are considered common area, accessible by Tenant and all other residents at reasonable times for reasonable purposes, unless otherwise indicated in writing.



Please select who pays for each utility
"Owner" = Owner Pays, "Tenant" = Tenant Pays, "N/A" = Not Provided

 Pays Electricity
 Pays Water
 Pays Sewer
 Pays Cable
 Pays Gas
 Pays Garbage

O = Owner Pays

T = Tenant Pays

N/A = Not Applicable

Move-in Accounting Rent & Deposits


Furnished to Unit

The unit has been equipped with exterior locks for all doors, and the following keys/openers provided:

Occupancy of Premises

Only the following person(s) shall occupy the premises:

Owner/Agent Contact Information

Payments may be made at the above address. Contact Owner/Agent for electronic or direct deposit payment options.

For Services of Notices to Owner/Agent

Include description of where at the property Tenant(s) may attach notice, such as “front door,” “drop slot,” “gate,” etc.

Emergency Contact for Tenant

Person to notify in case of emergency or death of Tenant:

Service Charge Disclosure

Utilities or Services benefiting Landlord, other Tenants or common area:
“Utility or Service” includes but is not limited to electricity, natural or liquid propane gas, oil, water, hot water, heat, air conditioning, cable television, direct satellite or other video subscription services, Internet access or usage, sewer service, public services and garbage collection and disposal.
Tenant Utility charges for this unit include:
Basis for allocation of utility or service charge for common areas (select one):
Name & address of third-party billing company, if any:

Utility charges billed are due within seven days of billing date or the date noted on the utility bill. Failure to pay charges when due constitutes a material violation of the Rental Agreement. If any bill for utilities or services remains unpaid for a period of more than 30 days, after issuance of a Notice of Noncompliance, Owner/Agent may charge Noncompliance Fees as allowed by law. Utility bills may be delivered by First Class Mail, email or personal delivery to the unit address.


Tenant(s) is allowed to park a maximum of
 vehicles on the premises.

Vehicle 1 Description:

Vehicle 2 Description:

Vehicle 3 Description:

Vehicle 4 Description:


Pets Allowed:
(if Yes, see Pet Agreement)







Tenant(s) is responsible for regular landscaping. (See attached Exterior Property Care Agreement)


  If boxes are checked, Tenant(s) agrees to allow the use of:


Rules & Regulations

  1. Guests: Written permission from the Owner/Agent is required if guest remains more than
     days/nights in any
     month period
    (if left blank then - seven (7) days/nights in any one-month period.)





Where used in this agreement “Owner/Agent” means “Landlord” as defined in ORS 90.100. All parties acknowledge having read and understand all pages and attachments to this agreement. All questions have been answered.


Please Note: Signature fields must be filled in and signed by all parties after printing.

Tenant Date   Tenant Date
Tenant Date   Tenant Date
Owner/Agent Date   Owner/Agent Date

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PO Box 20862, Keizer, OR 97307
eMail: forms@oregonrentalhousing.com