Page 1 Landlord Initials:________ Tenant(s) Initials:_______________
ASSURED SHORTHOLD TENANCY AGREEMENT The PROPERTY 1 Any Street, Anywhere, Anyshire AN1 B11
The LANDLORD Any Landlord
Of c/o Granger & Oaks, 2b-4b Hucknall Road, Nottingham, NG5 1AB
The TENANT Any Tenant
Of 2 Any Street, Anywhere, Anyshire, AN1 B11
The TENANT Any Other Tenant
Of 21 Any Street, Anywhere, Anyshire, AN1 B11
The TERM 12 Months
The RENT £500 per calendar month
The DEPOSIT £600
COMMENCING 1st January 2015
The INVENTORY means the list of the Landlord's possessions at the Property
Insert here the BINDING DATE of this contract
(only after this agreement has been signed by, or on behalf of, both parties)
THIS TENANCY AGREEMENT comprises the particulars detailed above and the terms and conditions printed
below whereby the Property is hereby let by the Landlord and taken by the Tenant for the Term at the Rent. The
“Term” is to include any periodic continuation of the tenancy beyond the fixed term.
NOTES TO TENANT(S)
1. ALL tenants listed on this agreement must initial every page of all copies of this contract
2. ALL tenants listed on this agreement must sign all copies of this contract
3. Please sign on the signature page AND on the last page
1. This Agreement is intended to create an assured shorthold tenancy as defined in the Housing Act 1988, as
amended by the Housing Act 1996, and the provisions for recovery of possession by the Landlord in that Act apply
accordingly. The Tenant understands that the Landlord will be entitled to recover possession of the Property at the
end of the Term.
In accordance with Sections 47 & 48 of the Landlord & Tenant Act 1987, notice is hereby given that the address at
which notices (including notices in proceedings) may be served by the tenant on the landlord is GO Property
Services, 2b-4b Hucknall Road, Nottingham NG5 1AB
Page 2 Landlord Initials:________ Tenant(s) Initials:_______________
As joint and several Tenants, the Tenant is responsible and liable for the following obligations under this agreement. This
means that any one of the members of a joint tenancy can be held responsible for the full rent and all obligations under
this agreement if other members do not fulfil their obligations.
2. The Tenant agrees to:
2.1 Acknowledge that the Tenant complied with the Landlord’s Agent’s requirements and completed the Tenant’s
Application Form and answered each and every question truthfully and faithfully and may be held in breach of this
agreement if he failed to do so.
2.2 Acknowledge that the Tenant or at least one of the joint Tenants will occupy the Property as his only or principal
home.
2.3 Pay, by bank Standing Order, the Rent whether formally demanded or not at the times and in the manner aforesaid
without any deductions whatsoever (save for any deduction allowable in law). If rent is not paid by Standing Order,
the tenant agrees to pay a £10 (inc vat) rent collection fee for each rental payment made.
2.4 Should a rent instalment remain unpaid for 3 days after the due date the Landlord or his Agent retains the right to
charge a late payment fee of £30 (inc vat). In addition, interest may be charged at the rate of 4% above the Base
Lending Rate for the time being of the Landlord's bankers upon any Rent or other money due from the Tenant under
this Agreement. If the Landlord or the Landlord’s agent is subsequently called upon to visit the property to collect
the rent in person, this will incur a rent collection fee of £30 per visit. (Visits will be made by mutually agreed
appointment and must be adhered to. Tenants not attending will incur a non-attendance fee of £40)
2.5 Not offset the rent against the Deposit referred to herein.
2.6 Register for and pay all charges in respect of any gas, electricity, fuel, water, telephone and television services
supplied to the Property and any Council Tax or any similar tax that might be charged in addition to or replacement
of it during the Term. Furthermore, the Tenant consents to the Landlord or his Agent advising the council and
service suppliers of the Tenant’s responsibilities.
2.7 Should the Tenant allow utility or other services at the Property to be cut off through non-payment either during or at
the end of the tenancy, to pay the costs associated with reconnection or resuming service.
2.8 In the event that the Tenant does not return to the Landlord or his Agent a signed copy of the Inventory, the Tenant
agrees to the accuracy of the Inventory provided at the commencement of the tenancy by the Landlord or his Agent.
2.9 In the event that a Contractor is called out unnecessarily to visit the Property because the Tenant has reported a
fault that is found not to exist or is due to the action or inaction of the Tenant; the Tenant has been provided with
details of a maintenance contract and the Tenant makes unnecessary use of a contractor; the Tenant makes use of
an out of hours emergency contractor in a non-emergency; the Tenant agrees to pay the costs associated with the
said within 7 days.
3. Use of the Property
3.1 Not do anything on or at the Property which is illegal or immoral.
3.2 Not do anything which may be or may become a nuisance or annoyance to the Landlord or owners or occupiers of
adjoining or nearby premises.
3.3 Not do anything which may in any way invalidate the insurance of the Property and the items listed on the Inventory
or cause an increase in the premium payable by the Landlord.
3.4 Use the Property only for the purpose of a private residence.
3.5 Not assign, sublet, charge, part with or share possession or occupation of the Property other than with the Tenant's
immediate family.
3.6 Not keep any pet or any kind of animal at the Property without the Landlord's prior consent.
3.7 Not smoke inside the property unless agreed in writing by the agent or landlord outside of this agreement.
3.8 Keep the interior of the Property and items on the Inventory in the same state of repair and condition as at the
commencement of the tenancy (fair wear and tear excepted) and will not deliberately damage the Property and
items on the Inventory. Should any repairs or maintenance be required as a result of the Tenant’s, his invited
guests or visitor’s negligence or misuse of the Property, the Tenant will be liable for the fair costs involved.
3.9 Notify the Landlord or his Agent of any disrepair which occurs at the Property. The Tenant must not carry out or
authorise repairs himself except in an emergency.
3.10 Permit the Landlord or anyone authorised by the Landlord at reasonable hours in the daytime and upon reasonable
prior notice (except in an emergency) to enter and view the Property and the items on the Inventory for any proper
purpose including any or all of the following:
a) To examine the condition of the Property or any adjoining or neighbouring property
b) To repair, maintain, alter, improve or rebuild the Property or any adjoining or neighbouring property
c) To examine or to repair, maintain or replace the items on the Inventory
d) To comply with any obligation imposed on the Landlord by law
e) To show the Property to a prospective purchaser, prospective Tenant or prospective mortgagee of the Property
3.11 Not to remove from the Property any of the Landlord’s Fixtures or Fittings or store them in the loft, basement,
garage or outbuildings (if any) without prior consent of the Landlord or his Agent. Where consent is granted, the
Tenant must ensure that items are stored safely as not to be damaged and returned from where they were removed
at the end of the tenancy.
3.12 Not make any alteration, decoration or addition to the Property internally or externally without the Landlord's or his
Agent’s prior consent.
Page 3 Landlord Initials:________ Tenant(s) Initials:_______________
3.13 Not to affix anything to the walls other than solely with a reasonable number of picture hooks and to be liable for
the fair costs of making good any unreasonable damage, marks, holes caused by such fixings or their removal.
3.14 To test any battery operated smoke alarm(s) in the Property and replace the batteries as necessary.
3.15 Should the Tenant bring into the Property any gas or electrical appliance(s), he must ensure they are safe to use. A
qualified GAS SAFE engineer must be used to install and remove any gas appliance. Should any appliance be found
to be unsafe, it must not be used and a qualified GAS SAFE engineer or electrician must be used to remove it.
3.16 To replace light bulbs, fluorescent tubes, fuses etc as necessary.
3.17 To unblock or clear any stoppages in any sink, basin, toilet, or waste pipe.
3.18 Not to put oil, grease or other harmful or corrosive substances into the washing or sanitary appliances or drains
within the Property or driveways.
3.19 To keep the property adequately heated and sufficiently aired and ventilated (by the opening of windows) in order to
prevent condensation. Where condensation does occur to wipe down and clean surfaces as required to prevent
mould growth or damage to the Property.
3.20 To take reasonable precautions to keep the Property free of infestation. Where infestation occurs as the result of
action or inaction by the Tenant, to be responsible for the appropriate costs involved in rectifying and or removing
the cause.
3.21 To take precautions to avoid damage from the freezing and bursting of pipes by adequately heating the Property.
3.22 To place all refuse in a proper receptacle and ensure that it is regularly collected by the local authority.
3.23 To cut the grass (if any) and keep the garden (if any) free from weeds and in a neat and tidy condition, not to cut
down or remove any trees or plants and not alter the layout of the garden or remove garden furniture or ornaments.
3.24 Not to repair any vehicles at the property apart from general maintenance to a vehicle which the tenant is a
registered keeper.
3.25 Not to keep any boat, caravan or commercial vehicle at the Property without prior consent.
3.26 Not to install or permit to be installed any additional aerial, satellite dish, cable television or telephone equipment
without prior consent of the Landlord or his Agent. Where consent is granted, the Tenant will meet all costs of
installation and subsequent removal (if required) and reasonable costs associated with making good any damaged
or decoration (if required). The Landlord or his Agent reserves the right to withdraw, with reasonable grounds, any
consent previously given.
3.27 To forward to the Landlord or his Agent any formal or legal documents which relate to the Property.
3.28 Not to replace or add any additional locks to the Property without prior consent of the Landlord or his Agent (except
in an emergency). Where new locks are installed, the Tenant undertakes to provide the Landlord or his Agent with a
full set of keys.
3.29 In the event that the washing machine, tumble dryer, refrigerator and freezer (if any) at the Property malfunctions,
the Tenant agrees not to seek reimbursement from the Landlord for any loss.
3.30 To pay all reasonable costs incurred in successfully enforcing or remedying a notable breach or significant failure to
comply with the obligations of the Tenant under this agreement.
3.31 To take all reasonable precautions to prevent the formation and growth of Legionella by, but not limited to, regularly
flushing and cleaning all shower heads and taps at the Property keeping them lime scale free and paying particular
attention to those shower heads and taps that are less regularly used (e.g. in a second bathroom).
4. Insurance and Security
4.1 To enter into a Insurance Policy from a recognised insurer that provides cover for accidental damage to the
contents, fixtures, fittings at the Property that belong to the Landlord and for that insurance cover to be maintained
for the duration of the tenancy.
4.2 In the event of loss or damage to the Property by fire, theft or other causes, to inform the authorities and Landlord
or his Agent as soon as is practical.
4.3 When the Property is left unattended to fasten securely all locks fitted to doors and windows of the Property and
ensure the burglar alarm (if any) is set.
4.4 Not to change any burglar alarm code (if any) without prior consent of the Landlord or his Agent.
4.5 To notify the Landlord or his Agent before leaving the Property unoccupied for any period more than 14 consecutive
days.
5. End of the Tenancy
5.1 To remove all the Tenant’s refuse and rubbish, belongings, property, personal effects, foodstuffs or furnishings and
equipment from the Property on or before the last day of the tenancy.
5.2 In the event that the Tenants belongings or any possessions have not been removed from the Property at the end of
the Tenancy, the Tenant will pay to the Landlord damages at the rate equal to the rent then payable for the Property
until the Tenant shall have removed all such belongings. In the event of them not being removed the Landlord shall
be entitled to remove, store or dispose the same at the Tenant’s expense.
5.3 Clean, to a professional standard, the Property and its Fixtures and Fittings, including any items included in the
Inventory.
5.4 To securely return all keys to the Property (including any new, additional or duplicate keys during the tenancy) to the
Landlord or his Agent during business hours on the last day of the Tenancy and pay the cost of replacing any lock
where such keys are missing. If the last day of the tenancy is at the weekend or during a public holiday the tenant
agrees to make the necessary arrangements to return keys during office hours and is aware that this may incur an
extra rental charge.
Page 4 Landlord Initials:________ Tenant(s) Initials:_______________
5.5 With the Landlord’s or his Agent’s prior consent and subject to certain conditions that may include the Landlord’s
costs associated with the re-letting of the Property, the tenant may be allowed to surrender or give up his tenancy
before it could otherwise lawfully be ended.
5.6 If at any time during the tenancy, the Tenant shall die or become incapacitated with the result that he can no longer
reside in the Property, the Tenant shall have the right to terminate the tenancy by giving to the Landlord or his Agent
notice of not less than one clear rental period notice in writing.
5.7 To pay to the Landlord or his Agent a check-out fee of £50 (inc vat) to cover end of tenancy administration which
includes the check-out and completing any tenancy reference requests.
5.8 To give the landlord or his agent notice to end this tenancy in accordance with the rental periods set-out in this
tenancy agreement. For periodic tenancies the tenant shall give a minimum of one clear rental periods notice, for
fixed term tenancies the tenant should give at least one clear rental periods notice to end on the last day of the
tenancy.
6. The Landlord agrees to
6.1 For as long as the Tenant performs his obligation under this Agreement allow the Tenant to peaceably hold and
enjoy the Property during the Term without unreasonable interruption from the Landlord or any person rightfully
claiming under or in trust for the Landlord.
6.2 Keep in repair the structure and exterior of the Property (including drains gutters and external pipes).
6.3 Keep in repair and proper working order the installations at the Property for the supply of gas, electricity and water
and for sanitation (including basins, sinks, baths and sanitary conveniences).
6.4 Keep in repair and proper working order the installation at the Property for space heating and heating water.
6.5 Take reasonable steps to ensure that the Landlord’s domestic gas and electrical appliances and other similar
mechanical appliances in the Property for which he is responsible are safe, in proper working order, and in repair
both at commencement of and during the tenancy, in order to comply with the Landlord’s obligations under the Gas
Safety (Installation and Use) Regulations 1998, the Electrical Equipment (Safety) Regulations 1994 and the Plugs
and Sockets etc., (Safety) Regulations 1994.
6.6 The Landlord warrants that all furniture and soft furnishings supplied at the Property comply (if appropriate) with the
provisions of the Furniture and Furnishings (Fire) (Safety) Regulations 1988 and the Furniture and Furnishings (Fire)
(Safety) (Amendment) Regulations 1993.
6.7 Where the Landlord supplies a working burglar alarm at the Property at the commencement of the tenancy, to keep
it in working order and repair but only where such a repair is not caused by misuse or negligence by the Tenant, his
invited guests or visitors.
6.8 Return to the Tenant any rent paid for any period while the Property is rendered uninhabitable by fire or other risk
for which the Landlord has agreed to insure. However, the Landlord is under no obligation to rehouse the Tenant or
to pay for any alternative accommodation.
But the Landlord will not be required to:
6.9 Carry out works for which the Tenant is responsible by virtue of his/her duty to use the Property in a tenant-like
manner.
6.10 Reinstate the Property in the case of damage or destruction if the insurers refuse to pay out the insurance money
due to anything the Tenant has done or has failed to do.
6.11 To keep in repair or maintain anything which the Tenant is entitled to remove from the Property.
6.12 Rebuild or reinstate the Property in the case of damage or destruction of the Property by a risk not covered by the
policy of insurance effected by the Landlord
7. The Deposit
7.1 The Deposit of £600 is paid by the Tenant to the Agent.
7.2 The Deposit is to be held by the Deposit Protection Service.
7.3 The Deposit has been taken for the following purposes:
a) Any damage, or compensation for damage, to the premises its fixtures and fittings or for missing items for which the tenant
may be liable, subject to an apportionment or allowance for fair wear and tear, the age and condition of each and any such
item at the commencement of the tenancy, insured risks and repairs that are the responsibility of the landlord.
b) The costs (£30 per hour (or equivalent)) incurred in compensating the landlord or his agent for, or rectifying or remedying
any breach by the tenant of the tenant’s obligations under the tenancy agreement, including those relating to, formally
documenting breaches, the organisation and administration involved to rectify or remedy any breach, including the cleaning
of the premises and repairs to the property’s fixtures and fittings.
c) Any sum which is or becomes repayable by the Landlord or his Agent to the Local Authority with regard to Housing Benefit
which has previously been paid directly to the Landlord or his Agent relating to the Tenant named in this agreement.
d) Any unpaid accounts for utilities, water charges or environmental services or other similar services or Council Tax incurred
at the Property for which the Tenant is liable.
e) Any rent or other money lawfully due or payable by the Tenant under the tenancy agreement of which the Tenant has been
made aware and which remains unpaid after the end of the tenancy.
7.4 At the end of the tenancy
7.4.1 The Agent will tell the tenant within 8 working days of the end of the tenancy if they propose to make any
deductions from the Deposit.
Page 5 Landlord Initials:________ Tenant(s) Initials:_______________
7.4.2 If there are no deductions to be made the Agent will confirm to the DPS by completing a Joint Deposit Repayment
Form, DPS will then require the tenant to do the same before they forward the deposit back to the tenant. If there
are agreed deductions the agent will advise DPS in the same way who will intern request agreement from the
tenant and then distribute funds accordingly.
7.4.3 If both parties cannot agree on deductions the DPS will appoint an Independent Case Examiner (‘ICE’) who will
examine the evidence presented by the landlord/ landlord’s agent and the tenant and decide on how the deposit
should be allocated.
7.4.4 By signing this agreement All parties agree to co-operate with the adjudication of the ICE
7.4.5 Failure to respond to the landlord / landlord’s agent within 14 days following the end of
the tenancy could result in the tenant losing part or all of their deposit.
7.4.6 The statutory rights of the Landlord and the Tenant to take legal action through the County Court remain unaffected
by clauses 7.4.1 – 7.4.5 above.
8. If at any time
a) any part of the Rent is outstanding for 10 days after becoming due (whether formally demanded or not) and/or
b) there is any breach, non-observance or non-performance by the Tenant of any covenant or other term of this Agreement
which has been notified in writing to the Tenant and the Tenant has failed within in reasonable period of time to remedy the
breach and/or pay reasonable compensation to the Landlord for the breach and/or
c) any interim receiver is appointed in respect of the Tenant's property or Bankruptcy Order made in respect of the Tenant or
the Tenant makes any arrangement with his creditors or suffers any distress or execution to be levied on his goods and/or
d) any of the grounds set out as Grounds 8 or Grounds 10-15 (inclusive) (which relate to breach of any obligation by a Tenant)
contained in the Housing Act 1988 Schedule 2 apply
The Landlord may enter the Property (and upon such re-entry this Agreement shall absolutely determine but without
prejudice to any claim which the Landlord may have against the Tenant in respect of any antecedent breach of any
covenant or any term of this Agreement). This right of re-entry is not to be exercised by the Landlord without a court
order while anyone is residing in the Property or while the tenancy is an assured tenancy.
9. The Landlord hereby notifies the Tenant in accordance with Section 48 of the Landlord and Tenant Act 1987 that
his address for service is that stated with the name of the Landlord on the first page of this Agreement.
10. In the event of damage to or destruction of the Property by any of the risks insured against by the Landlord the
Tenant shall be relieved from payment of the Rent to the extent that the Tenant's use and enjoyment of the Property
is thereby prevented and from performance of its obligations as to the state and condition of the Property to the
extent of and so long as there prevails such damage or destruction (except to the extent that the insurance is
prejudiced by any act or default of the Tenant) the amount in case of dispute to be settled by arbitration.
11. This agreement is subject to all laws and statutes affecting Assured Shorthold Tenancies. Should a court decide
that some part of the agreement is invalid or un-enforceable, the rest of the agreement will still be valid and binding
on all parties.
12. Where the context so admits
12.1 The 'Landlord' includes the persons from time to time entitled to receive the Rent
12.2 The 'Tenant' includes any persons deriving title under the Tenant
12.3 The 'Property' includes any part or parts of the Property and all of the Landlord's fixtures and fittings, furniture,
furnishings, sanitary ware, decorative features, white goods, other equipment or any floor, ceiling or wall coverings
and includes anything listed in any Inventory and/or Schedule of Condition as supplied at or upon the Property.
12.4 The 'Term' shall mean the period stated in the particulars on the first page of this Agreement or any shorter or
longer period in the event of an earlier termination or an extension or holding over respectively.
13. Any reference to either one gender includes the other and any reference in the singular shall include the plural if
appropriate and vice versa and any obligations or liabilities of more than one person shall be joint and several and
an obligation on the part of a party shall include an obligation not to allow or permit the breach of that obligation.
14. Special Tenancy Conditions
14.1 It is agreed between the parties that if the Landlord wishes to terminate the tenancy, he must give the required two
month’s notice in writing to the tenant in accordance with Section 21 of the Housing Act 1988. This notice can be
served upon the Tenant at any time but such notice cannot expire earlier than the end of the fixed term of the
tenancy.
14.2 If after the expiry of the fixed term both parties wish to extend the tenancy a fee of £40 + VAT will be payable by the
Tenant for renewing or extending the tenancy agreement irrespective of the length of the extended period or type of
agreement.
14.3 It is agreed between the parties that where the Tenant leaves the Property unoccupied, without prior notice in
writing to the Landlord or Agent, for a prolonged period, the Tenant has failed to pay rent for that period, and has
shown no intention of returning to the Property, the Landlord may treat these actions as a surrender of the tenancy,
take possession of the Property, change the locks at the Tenant’s expense, and re-market the Property.
Furthermore, provided the Tenant has been notified or if the Landlord or Agent have been unable to contact the
Tenant after reasonable steps have been taken, any possessions of the Tenant left at the property may be disposed
of after 14 days at the Tenant’s expense.
Page 6 Landlord Initials:________ Tenant(s) Initials:_______________
LA
ND
LO
RD
/
AG
EN
T Signed by Landlord X
Granger & Oaks
on behalf of Any Landlord
TE
NA
NT
Signed by Tenant X
Any Tenant
TE
NA
NT
Signed by Tenant X
Any Other Tenant
Page 7 Landlord Initials:________ Tenant(s) Initials:_______________
PRESCRIBED INFORMATION RELATING TO TENANCY DEPOSITS
The Deposit Protection Service
NOTE: The Landlord/Agent must supply the Tenant with the Prescribed Information regarding any tenancy deposit required
to be dealt with under the custodial tenancy deposit scheme.
To: Any Tenant & Any Other Tenant
1. The name, address and contact details of the Scheme Administrator of the Tenancy Deposit Scheme that is
safeguarding your tenancy deposit is:
The Deposit Protection Service (The DPS)
The Pavilions
Bridgwater Road
Bristol
BS99 6AA
Telephone No. 0844 4727 000
Online: Enquiry Forms are available through the Virtual Customer Service Agent or the
Frequently Asked Questions at www.depositprotection.com
2. Information contained in a leaflet supplied by the Scheme Administrator to the Landlord explaining the operation of the
provisions contained in the statutory scheme.
See attached Terms and Conditions.
3. Information on the procedures applying for the release of the deposit at the end of the tenancy.
See attached Terms and Conditions.
4. Procedures that apply under the Scheme where either the Landlord or the Tenant is not contactable at the end of the
tenancy.
See attached Terms and Conditions.
5. Procedures that apply under the Scheme where the Landlord and the Tenant dispute the amount to be repaid to you in
respect of the deposit.
See attached Terms and Conditions.
6. The facilities available under the Scheme for enabling a dispute relating to the deposit to be resolved without recourse to
litigation.
There is an alternative Dispute Resolution Scheme available enabling an independent adjudicator to decide on any dispute.
See attached Terms and Conditions for further information
* In accordance with The Housing (Tenancy Deposits) (Prescribed Information) Order 2007.
7. Tenancy specific information
(a) Amount of deposit paid.
£600
(b) Address of property to which the tenancy relates.
1 Any Street
Anywhere
Anywhire
(c) Name, address and details of Landlord(s)/Agent
Name: Granger & Oaks
Address including postcode:
2b-4b Hucknall Road
Nottingham
NG5 1AB
0115 9629770
(d) Name, address and contact details of the Tenant(s) (in case of joint tenants insert information for all tenants).
(1) Name: ……………………………………………………………………………………………….
Address including postcode:
……………………………………………………………………………………………………………….
Page 8 Landlord Initials:________ Tenant(s) Initials:_______________
……………………………………………………………………………………………………………….
……………………………………………………………………………………………………………….
……………………………………………………………………………………………………………….
Telephone number(s): ………………………………….…………………………………………
Email address(es): ………….……………………………………………………………………....
Fax Number(s): …………………………………….…………………………………………………
Contact address to be used by The Landlord / Agent at the end of the tenancy:
………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………..
(2) Name: ……………………………………………………………………………………………….
Address including postcode:
……………………………………………………………………………………………………………….
……………………………………………………………………………………………………………….
……………………………………………………………………………………………………………….
……………………………………………………………………………………………………………….
Telephone number(s): ………………………………….…………………………………………
Email address(es): ………….……………………………………………………………………....
Fax Number(s): …………………………………….…………………………………………………
Contact address to be used by The Landlord / Agent at the end of the tenancy:
………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………..
(3) Name: ……………………………………………………………………………………………….
Address including postcode:
……………………………………………………………………………………………………………….
……………………………………………………………………………………………………………….
……………………………………………………………………………………………………………….
……………………………………………………………………………………………………………….
Telephone number(s): ………………………………….…………………………………………
Email address(es): ………….……………………………………………………………………....
Fax Number(s): …………………………………….…………………………………………………
Contact address to be used by The Landlord / Agent at the end of the tenancy:
………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………..
(4) Name: ……………………………………………………………………………………………….
Address including postcode:
……………………………………………………………………………………………………………….
……………………………………………………………………………………………………………….
……………………………………………………………………………………………………………….
……………………………………………………………………………………………………………….
Telephone number(s): ………………………………….…………………………………………
Email address(es): ………….……………………………………………………………………....
Fax Number(s): …………………………………….…………………………………………………
Contact address to be used by The Landlord / Agent at the end of the tenancy:
………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………..
Note: please see Note 3 below regarding the tenant’s or lead tenant’s responsibility to register their contact address with
The DPS and to ensure that address is updated at the end of the tenancy.
(e) Name of Third Party making the payment: …………………………………….………
Address including postcode:
…………………………………….…………………………………………………………………………….…
…………………………………….…………………………………………………………………………….…
…………………………………….…………………………………………………………………………….…
Page 9 Landlord Initials:________ Tenant(s) Initials:_______________
Telephone number(s): …………………………………….………………………………………………
Email address(es): …………………………………….……………………………………………………
Fax Number(s): …………………………………….…………………………………………………………
Note: If there are additional third parties, please attach a continuation sheet with the same information for the further third
parties.
(f) Circumstances when all or any part of the deposit may be retained by the Landlord.
Refer to Clause(s) of Tenancy Agreement.
Clause 7.4
I/We (being the landlord/agent) certify that:
(i) The information provided is accurate to the best of my/our knowledge and belief.
(ii) I/We have given the Tenant(s) the opportunity to sign this document by way of confirmation that the
information is accurate to the best of the Tenant(s) knowledge and belief.
Signed by Landlord /
Agent X
Signed by Tenant X
Signed by Tenant X
NOTES
(1) A copy of the Deposit Protection Service Terms and Conditions must be attached to this document.
It is available to download from http://www.depositprotection.com/documents/terms-and-conditions.pdf
(2) The tenant(s) and relevant persons (if any) agree that the lead tenant has been nominated by all the joint tenants and
any relevant persons and that the responsibilities of the lead tenant are fully understood by all tenants. The responsibilities
are detailed in Section 8 of the attached Terms and Conditions.
(3) It is the tenant’s or lead tenant’s (where relevant) responsibility to register their contact address with The DPS and to
ensure that address is updated at the end of the tenancy.
(4) The document is provided by The DPS by way of information only. The DPS accepts no liability for it’s contents. It is the
landlord(s) responsibility to ensure it is completed accurately, served on the tenant(s) within 30 days of receipt of deposit
and to give the tenant(s) an opportunity to check and sign this document.
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