Type of Agreement: Type of Agreement: New Agreement Among RoommatesNew Tenant joining a Roommate Agreement Number (#) of Roommates How many Roommates, in total, will be living on the Property? 2345678910Roommates If the Landlord is living in the same residence, he or she would count as a Roommate. The Roommates Enter each roommate's full name. Roommate #1 (Name of New Roommate) First Last Roommate #1 First Last Roommate #2 First Last Roommate #3 First Last Roommate #4 First Last Roommate #5 First Last Roommate #6 First Last Roommate #7 First Last Roommate #8 First Last Roommate #9 First Last Roommate #10 First Last Property Address Address Street Address Address Line 2 City Please SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington DCWest VirginiaWisconsinWyoming State ZIP Code Would you like to provide an Additional Description to the Property? NoYes If the roommates would like to further describe exactly which rooms will be shared. Additional Description of the Property Term of Roommate Agreement Start Date End Date Security Deposit Security Deposit (For the New Roommate ONLY) $ If there is no Security Deposit write "0" Security Deposit Amount (for ALL Roommates) $ This is the amount that is paid or being held by the Landlord. Will the Security Deposit be paid equally amongst the Roommates? YesNo If No, explain how much each Roommate will pay Describe the roommates Security Deposit payment structure. Rent How much will the New Roommate pay in rent? $ How much will the Roommates collectively pay in rent? $ What is the total rent amount to be paid by the Roommates as a whole? Will all the Roommates be paying an equal amount in rent? YesNo Explain the Rental Amounts to be paid by EACH ROOMMATE: Payment Details Is rent to be paid on a monthly or weekly basis? MonthlyWeekly Which day of the month will rent be paid? 1st2nd3rd4th5th6th7th8th9th10th11th12th13th14th15th16th17th18th19th20th21st22nd23rd24th25th26th27th28th29thLast Dayday of the month Which day of the week will rent be paid? MondayTuesdayWednesdayThursdayFridaySaturdaySunday Rent Payment Instructions Payment Instructions for each Roommate: All payments should be made separately by each Roommate to the Landlord. Utilities and Services What percentage (%) of all the Utilities will the New Roommate have to pay? Percent (%) Will there be any Utilities or Services that the New Roommate will not have to pay for? YesNo List any Utilities or Services that the New Roommate WILL NOT be responsible for? List the Utilities and Services paid by the Roommates: "Cable, internet, electricity, and Netflix." Will all the Utilities and Services be paid equally amongst the Roommates? YesNo Describe the payment structure for the Utilities and Services: Additional Terms & Conditions Are there any Additional Terms or Conditions to this Agreement? YesNo For example, if there is a pet policy, rules for guests, cleaning, etc. In Addition to this Agreement, the Roommates collectively agree that: Disclosures Was the Property Built prior to 1978? YesNo If Yes, the Lead-Based Paint Disclosure Form must be attached to this Agreement. Will there be a Move-in Checklist completed at the time of move-in? YesNo Available to Sign Are the Roommates together and available to sign online? Are the Roommates together and available to sign online? YesNo Signature Page When will the agreement be signed? New Roommate Signature Clear Please draw your signature. Roommate #1 Signature Clear Please draw your signature. Roommate #2 Signature Clear Please draw your signature. Roommate #3 Signature Clear Please draw your signature. Roommate #4 Signature Clear Please draw your signature. Roommate #5 Signature Clear Please draw your signature. Roommate #6 Signature Clear Please draw your signature. Roommate #7 Signature Clear Please draw your signature. Roommate #8 Signature Clear Please draw your signature. Roommate #9 Signature Clear Please draw your signature. Roommate #10 Signature Clear Please draw your signature. Next Save Save and finish later
