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V4 : ONE-TIME LATE PAYMENT AGREEMENT

 

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et al (and all others)
 
 
 
 , OREGON
 
Tenant(s) agree(s) that the total rent due shall be paid on 
 
FOR THIS MONTH ONLY.
RENT DUE: 
 
LATE CHARGE: 
 
BALANCE DUE: 
 
 

Please Note: Form must be signed and dated by all Parties after printing.

 
Tenant Date   Tenant Date
 
Tenant Date   Tenant Date
 
Tenant Date   Tenant Date
Owner/Agent Signature:   Date: 

MAKE PAYMENTS TO:

Owner/Agent may terminate the tenancy for nonpayment of Rent based on a termination notice. Such notice may be served prior to the agreed upon payment date.

Owner/Agent does not waive the right to terminate by simultaneously or subsequently served notices.

V4 : ONE-TIME LATE PAYMENT AGREEMENT
Rev.4/16

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