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V5 : ONE-TIME PARTIAL PAYMENT AGREEMENT

 

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et al (and all others)
 
 
 
 , OREGON
 
 

Tenant(s) agree(s) that Owner/Agent’s acceptance of partial rent for this rental period does not waive Owner/Agent’s right to terminate for nonpayment of Rent. Owner/Agent may terminate the tenancy for nonpayment of Rent based on a termination notice (which may be served simultaneously, subsequently or prior to the agreed upon payment date).

 
Total Rent Owed:
Late Charge:
Other:
Other:
Other:
Less Payment Made Today:
Total To Be Paid:
 
Tenant(s) agrees to pay balance due of
 
 by this date and time:
 
.
 
 

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

V5 : ONE-TIME PARTIAL PAYMENT AGREEMENT
Rev.4/16

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