Personal Rooming List

PERSONAL ROOMING LIST

Property Name:    Property Address:

Manager/Owner Name:    Manager Contact Phone:

Effective Date of List:    List Prepared By (printed):

ROOMING ASSIGNMENTS

Complete one row for each room or bed currently occupied or reserved. Attach additional sheets if necessary.

FINANCIAL TERMS

Rent Due Date Each Month:    Late Fee:

Cash    Check    Electronic Transfer    Other:

HOUSE RULES & OCCUPANCY

Maximum Occupancy for Property:    Quiet Hours:

Smoking Allowed: Yes    No    Pets Allowed: Yes    No    If yes, specify limits:

INVENTORY AND CONDITION

Document known furniture, fixtures and general condition for each assigned room. Manager and Resident representative should initial attached inventory when required.

EMERGENCY CONTACT & ADDITIONAL INFORMATION

CERTIFICATIONS AND NOTICES

Accuracy and Consent: By signing below the Manager and Resident representative certify that the information on this Rooming List is true and complete to the best of their knowledge. Manager and Resident authorize the exchange of information necessary to administer occupancy, payment and safety obligations and to comply with applicable law.

Occupancy and Liability: Occupants listed are authorized to occupy the indicated rooms only. Manager is not responsible for personal property loss, except where required by law. Each occupant is responsible for conduct of their guests and for reporting damage, hazards or criminal activity immediately.

Termination and Changes: This Rooming List is an administrative record. Manager may update the list upon lawful notice to occupants. Removal or addition of occupants may require separate written agreements, consents or notices as required by local regulation or lease terms. False statements may constitute grounds for termination and lawful remedies.

Record Retention: This document will be retained by the Manager as a record of occupancy. The Resident representative has received a copy of this Rooming List where applicable.

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