ORHA Logo

Complete Your Custom ORHA Rental Form

shopping cart

Please Fill In the Form


 

FormT5PD : PORTLAND NOTICE OF TERMINATION

QUALIFYING LANDLORD REASON

Please Note: This version of the "Portland Notice of Termination Qualifying Landlord Reason" form is for use with Rental Properties within the City of Portland, Oregon ONLY.
To switch to the standard Oregon State version of this form click the button below.

 

Required entries are indicated by blue icons or *

et al (and all others)




 
Owner/Agent hereby serves you 90 days' notice of the termination of your tenancy for a Qualifying Landlord Reason:
 
 
 
 
 
Your tenancy is being terminated and you must vacate the Rental Unit you now occupy no later than 11:59 p.m. (end of day) on
 
 
The facts which support this notice are:
 
 
RELOCATION FEE - If the Owner of the Dwelling Unit has an ownership interest in more than four residential Rental Units subject to ORS Chapter 90, a Relocation Fee of one month’s Periodic Rent is required to be paid to the Tenant(s) at the time this notice is delivered. Termination of tenancy for a Qualifying Landlord Reason for rental properties located within the Portland city limits may also require a City of Portland Relocation Fee, unless exempt. If required the Fee varies based on the number of bedrooms, and is required to be paid within 45 days of service of the Notice of Termination. Both Fees must be paid at the time prescribed by law; however, the required Portland Fee may be reduced by the amount of the state Fee previously paid. Visit: https://www.portland.gov/phb/rental-services/renter-relocation-assistance to learn more.
 
 

If your Termination Date is not at the end of your Rental Period, and you have not paid a Last Month’s Rent Deposit, you will owe Rent for a partial month.

Your prorated Rent from
 
 through
 
 is
 

If you did pay a Last Month’s Rent Deposit that exceeds the Date of Termination, the Landlord is required to account for those funds separately at the time of Security Deposit Reconciliation within 31 days of Surrender of Possession of the Dwelling Unit.

 

Please Note: Signature field must be filled in and signed after printing.

Owner/Agent Signature:   Date:
 

The following forms are required to be included with this form by the City of Portland, OR


Portland Notice of Security Deposit Rights

 
et al (and all others)

 

30.01.087 Security Deposits; Pre-paid Rent.(Added by Ordinance No. 189581; amended by Ordinance Nos. 189715, 190064 and 190905, effective July 29, 2022.) In addition to the protections set forth in the Oregon Residential Landlord and Tenant Act (“Act”) and in Sections 30.01.085 and 30.01.086, the following additional Tenant protections regarding Security Deposits apply to Rental Agreements for a Dwelling Unit covered by the Act. For purposes of this Section, unless otherwise defined in this Section or elsewhere in Chapter 30, capitalized terms have the meaning set forth in the Act.

 
 
Portland Housing Bureau Letterhead


Rental History Form Required Under Portland City Code Title 30.01.087.F

Within the City of Portland, a landlord is required to provide this completed form to a Tenant within 5 business days of receiving a request from a tenant, receiving notice from the Tenant of intent to terminate the tenancy, or when a Landlord gives notice of intent to terminate a tenancy. This form may be transmitted in digital or paper form.

Tenant Information

Tenant Name:
 
 

Landlord Information

Landlord Name:
 
Contact Information:
 

Residency Information

Address:
 
Move-in Date:
 
Move-out Date (if known):
 
 

Please Note: Signature field must be filled in and signed after printing.

 
Landlord Signature   Date

Rental History Form
Form 30.01.087.F (Valid through 12/31/2022)
Page 1 of 3

Equal Housing Opportunity
 

Previous Two-Year Rent Payment History (A payment ledger detailing the same information may be used to meet the requirements of this form)

COVID-19 Guidance: A lanlord may choose to indicate 'Deferred' on months where rent payment has been deferred under local, state or federal eviction moratoria

 

Note: Entering or changing the month, year and paid Rent information for the first entry will automatically populate the remaining entries.
The remaining entries
can then be adjusted as needed.
The first entry
should be the oldest, but no more than two years back.

Month:
 
Year:
 
Paid?
 

Month:
 
Year:
 
Paid?
 

Month:
 
Year:
 
Paid?
 

Month:
 
Year:
 
Paid?
 

Month:
 
Year:
 
Paid?
 

Month:
 
Year:
 
Paid?
 

Month:
 
Year:
 
Paid?
 

Month:
 
Year:
 
Paid?
 

Month:
 
Year:
 
Paid?
 

Month:
 
Year:
 
Paid?
 

Month:
 
Year:
 
Paid?
 

Month:
 
Year:
 
Paid?
 

Month:
 
Year:
 
Paid?
 

Month:
 
Year:
 
Paid?
 

Month:
 
Year:
 
Paid?
 

Month:
 
Year:
 
Paid?
 

Month:
 
Year:
 
Paid?
 

Month:
 
Year:
 
Paid?
 

Month:
 
Year:
 
Paid?
 

Month:
 
Year:
 
Paid?
 

Month:
 
Year:
 
Paid?
 

Month:
 
Year:
 
Paid?
 

Month:
 
Year:
 
Paid?
 

Month:
 
Year:
 
Paid?
 

Rental History Form
Form 30.01.087.F (Valid through 12/31/2022)
Page 2 of 3

 
Equal Housing Opportunity
 

If you believe you have been harassed or discriminated against because of your race, color,
national origin, religion, gender, familial status, disability, marital status, source of income,
sexual orientation including gender identity, domestic violence, type of occupation,
or age over 18 seek legal guidance regarding your rights under Fair Housing law.

 

For translation or interpretation, please call 503-823-1303
TTY at 503-823-6868 or Oregon Relay Service at 711

 

503-823-1303: Traducción e interpretación | Chuyển Ngữ hoặc Phiên Dịch | 翻译或传译
Письменныйили устный перевод | 翻訳または通訳| Traducere sau Interpretare
번역 및 통역 | Письмовий або усний переклад | Turjumida ama Fasiraadda
ةيوفشلاو ةيريرحتلا ةمجتر لا | ການແປພາສາ ຫຼື ການອະທິ ບາຍ

 

This requirement is in addition to any other rights and responsibilities set forth in the Oregon
Residential Landlord and Tenant Act under Oregon Revised Statute Chapter 90, and Portland
Landlord-Tenant Law under Portland City Code Title 30.

 

The information in this form is for educational purposes only. You should review appropriate
state statute, city code, and administrative rule as necessary. If you need legal guidance, or are
considering taking legal action, you should contact an attorney.

Rental History Form
Form 30.01.087.F (Valid through 12/31/2022)
Page 3 of 3

 
Portland Housing Bureau Letterhead

Tenant Notice of Rights and Responsibilities

Portland City Code 30.01.085

Mandatory Renter Relocation Assistance

For residential rental units within Portlnd city limits, these rights and responsibilities are in addition to protections set forth in the Oregon Residential Landlord and Tenant Act under Oregon Revised Statute Chapter 90, and Portland Landlord-Tenant Law under Portland City Code Title 30.

Landlords must include this notice (or another notice with similar information) with each and any Termination Notice, Increase Notice, and Relocation Assistance Payment

The information in this notice is for educational purposes only. You should review appropriate state statute, city code, and administrative rule as necessary. If you need legal guidance, or are considering taking legal action, you should contact an attorney.

 

No Cause Evictions and Non-Renewals

If your Landlord is ending your rental agreement without a tenant-based cause, you have the right to a written notice of termination at least 90 days before the termination date designated in the notice. Your landlord may have the obligation to pay you relocation assistance at least 45 days before the termination date designated in the notice.

 

Qualifying Landlord Reason for Termination

If your Landlord is ending your rental agreement for a qualifying landlord reason, you have the right to a written notice of termination at least 90 days before the termination date designated in the notice. Your landlord may have the obligation to pay you relocation assistance (city requirement) and/or one month’s rent (state requirement).

If both are owed, your landlord has two options for paying relocation assistance and one month’s rent owed:

  1. They can pay you relocation assistance or one month’s rent (whichever is higher) in a single payment not later than day they deliver the termination notice; or
  2. They can pay you two payments, one month’s rent when delivering the notice and, pay you relocation assistance at least 45 days before the effective date of the notice.
 

Rent Increases

 

Notice 30.01.085.D
V3 VED: 1Aug22
Page 1 of 3

 
Portland Housing Bureau Letterhead

If your Landlord raises your rent, you may have the right to a written notice of the rent increase at least 90 days before the effective date of the rent increase. The increase notice must state the amount of the increase, the amount of the new rent or housing costs, and the effective date of the increase.

If your Landlord raises your rent by amounts totaling 10% or more during any 12-month period, you may have the right to request relocation assistance. You must write to your Landlord within 45 days of receiving a rent increase to request relocation assistance. Your landlord then has the obligation to pay you the relocation assistance amount within 31 days of receiving your notice. You then have the obligation to, within 6 months, either pay back the relocation assistance and stay or provide your Landlord with written notice that you’re terminating your tenancy and then move out. Either way, you must pay the increased rent while you continue to rent the unit.

 

Relocation Assistance Amount

Unless your landlord is exempt you may have the right to the relocation amount as listed below. Amounts are dependent on the number of bedrooms being rented on a rental agreement. You have the right to one relocation assistance amount per rental agreement, not per tenant.

Studio, SRO, or rented bedroom in a shared house: $2,900

One-bedroom unit: $3,300

Two-bedroom unit: $4,200

Three-bedroom unit or larger: $4,500

 

Exemptions

In some circumstances, your landlord may be exempt from paying relocation assistance. Most exemptions require the landlord to provide to the tenant an Acknowledgement Letter from PHB. If you receive an Acknowledgement Letter, closely review it for details about the exemption. For more information, visit [https://www.portland.gov/phb/rental-services/renter-relocation-assistance] or call the PHB Rental Services Office at 503-823-1303.

If your Landlord is ending your rental agreement without a tenant-based cause, you have the right to a written notice of termination at least 90 days before the termination date designated in the notice. Your landlord may have the obligation to pay you relocation assistance at least 45 days before the termination date designated in the notice.

 

Penalties

If your Landlord does not meet their obligations under Portland’s relocation assistance law you may have the right to legal recourse to protect your rights. A Landlord that fails to comply with any of the requirements above may owe you up to 3 times your rent as well as the Relocation Assistance amount, reasonable attorney fees and other costs.

 

Notice 30.01.085.D
V3 VED: 1Aug22
Page 2 of 3

 
Portland Housing Bureau Letterhead
Equal Housing Opportunity
 

If you believe you have been harassed or discriminated against because of your race, color,
national origin, religion, gender, familial status, disability, marital status, source of income,
sexual orientation including gender identity, domestic violence, type of occupation,
or age over 18 seek legal guidance regarding your rights under Fair Housing law.

 

For translation or interpretation, please call 503-823-1303
TTY at 503-823-6868 or Oregon Relay Service at 711

 

503-823-1303: Traducción e interpretación | Chuyển Ngữ hoặc Phiên Dịch | 翻译或传译
Письменныйили устный перевод | 翻訳または通訳| Traducere sau Interpretare
번역 및 통역 | Письмовий або усний переклад | Turjumida ama Fasiraadda
ةيوفشلاو ةيريرحتلا ةمجتر لا | ການແປພາສາ ຫຼື ການອະທິ ບາຍ

 
 

Notice 30.01.085.D
V3 VED: 1Aug22
Page 3 of 3


  • Click "Preview Form" below to check your information.
  • If the form is correct, close the preview to return to this page, then click "Generate PDF". Your form will be created and added to your cart.
  • From your cart, you can return to the Forms Store to create more forms, delete forms from your cart or purchase the items in your cart.

© 2019-2022 Oregon Rental Housing Association - All Rights Reserved
PO Box 20862, Keizer, OR 97307
eMail: office@oregonrentalhousing.com