Housing Release Form

HOUSING RELEASE FORM

This Housing Release Form (the "Agreement") is made as of by and between Resident Name: whose address for notice is (hereinafter "Resident"), and Housing Provider Name: whose address for notice is (hereinafter "Provider").

RECITALS

WHEREAS, Resident is currently occupying the housing unit located at (the "Premises") under a rental agreement or lease; and

WHEREAS, Resident intends to vacate the Premises on or about and seeks to provide Provider with an express release and surrender of possession and claims; and

WHEREAS, Provider is willing to accept surrender of possession and to make accounting for any security deposit or other sums in accordance with the terms of this Agreement.

NOW, THEREFORE, in consideration of the mutual covenants and agreements contained herein, the parties agree as follows:

1. DEFINITIONS

For purposes of this Agreement, "Premises" means the unit identified above, "Effective Date" means the date first written above, and "Claims" means any and all past, present or future causes of action, demands, rights, liabilities and obligations of any kind whether known or unknown, asserted or unasserted, in law or in equity, arising out of or relating to the tenancy, the condition of the Premises, or the rental agreement.

2. SURRENDER OF POSSESSION

Resident hereby surrenders and delivers possession of the Premises to Provider on the move-out date specified above or on such earlier date as Resident vacates and returns all keys. Resident agrees to leave the Premises free of personal property except as otherwise agreed in writing. Resident acknowledges that keys are returned: Yes

3. CONDITION; INSPECTION

Resident represents that, to the best of Resident's knowledge, the Premises are being surrendered in substantially the same condition as on move-in, ordinary wear and tear excepted. The parties agree to conduct a joint inspection on or about the move-out date. Any known damages or required repairs are described below:

4. SECURITY DEPOSIT; ACCOUNTING

Provider shall account for and, if applicable, return the security deposit or the balance thereof to Resident within the period required by applicable law, less lawful deductions for unpaid rent, repairs for damages beyond normal wear and tear, and other authorized charges. The parties acknowledge the following:

5. FORWARDING ADDRESS

Resident's forwarding address for purposes of return of deposit and any required notices is:

6. MUTUAL RELEASE; COVENANT NOT TO SUE

Upon Provider's receipt of possession and any agreed sums, Resident releases and forever discharges Provider and its agents, employees and affiliates from all Claims arising out of or related to the tenancy or the Premises through the Effective Date, except for obligations expressly stated in this Agreement. Resident covenants not to commence or prosecute any action or proceeding against Provider based upon such released Claims.

7. INDEMNIFICATION

Resident shall indemnify and hold Provider harmless from any liabilities, costs, losses or damages (including reasonable attorneys' fees) arising from Resident's failure to remove personal property, from Resident's negligent acts or omissions on the Premises prior to surrender, or from any breach of Resident's representations and warranties contained herein.

8. REPRESENTATIONS AND WARRANTIES

Resident represents and warrants that Resident has authority to execute this Agreement, that all rent and charges through the Effective Date have been disclosed, and that there are no pending judgments or claims against the Premises other than those disclosed in writing to Provider prior to execution.

9. NOTICES

All notices required or permitted hereunder shall be in writing and delivered to the addresses set forth at the beginning of this Agreement or to such other address as either party may designate by written notice. Notice shall be effective upon personal delivery or three days after deposit with the postal service by certified mail, return receipt requested.

10. AMENDMENT; WAIVER

This Agreement may be amended only by a written instrument executed by both parties. No waiver of any breach of this Agreement shall be a waiver of any other or subsequent breach.

11. GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the state where the Premises is located, without regard to principles of conflicts of law.

12. ENTIRE AGREEMENT; SEVERABILITY; COUNTERPARTS

This Agreement constitutes the entire understanding between the parties concerning the subject matter hereof and supersedes all prior negotiations, representations or agreements, whether written or oral. If any provision is held invalid or unenforceable, the remainder shall continue in full force and effect. This Agreement may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one instrument.

ADDITIONAL ACKNOWLEDGMENTS

Resident acknowledges receipt of a copy of this Agreement and that Resident has had an opportunity to review it prior to signing. Resident further acknowledges that Resident has removed all personal property and left the Premises as described above except for the items specifically listed in this Agreement.

Sign Now