DISCLOSURE OF SHARED UTILITIES ARRANGEMENTS
THIS AGREEMENT made and entered into between ________________________________,
“Landlord" and ________________________________, ________________________________,
________________________________, and ________________________________, Tenant(s)”.
Tenant(s) is renting from Landlord the Property located at: __________________________
____ This rental unit shares the following utilities with another unit or common area:
____ Other: _________________________________________
____ This lease uses the following method for calculating utility charges between
____ Home Square Footage
____ Number of Tenants
____ Even Split Between Tenants
____Tenant agrees to pay the monthly utility charge to Landlord, plus a $___________
service charge as part of each month’s rental payment.
CERTIFICATION OF ACCURACY
The following parties have reviewed the information above and certify, to the best of
their knowledge, that the information they have provided is true and accurate.
Landlord Date Landlord Date
Tenant Date Tenant Date
Agent Date Agent Date