Free roommate agreement template 01Free roommate agreement template 01
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Room Only Accommodation Agreement
(Boarders & Lodgers)
An agreement to rent accommodation

(the premises)
made on (date)


(1) Name of occupant: ______________________
Family Name

Given Names

(2) Name of occupant: ______________________
Family Name

Given Names

Name of Accommodation Provider:
Family Name

Given Names

Address of landlord if not the same as above at ‘the premises’:

Accommodation providers contact phone number:
The Accommodation Provider Agrees To:
 Pay rates, taxes, telephone rental and maintenance (if the home owner)
 Provide and maintain the premises in good order and condition
Allow the occupant access to and use of the bedroom (as inspected) and: ( applicable)
 Kitchen
 Family Room
 Laundry
 Bathroom/toilet
 Garage
 Pool/Garden
 Other (describe)
Provide the following additional services at no extra charge: (tick if applicable)
 Breakfast
 Lunch
 Dinner
 Ironing
 Laundry
 Cleaning
 Other (describe)
Allow the occupan