Email
example@example.com
What is the full name of the Tenant (or Tenants, if multiple)?
*
First Name
Last Name
What is the full name of the Landlord?
What is the effective date of this lease extension?
/
Month
/
Day
Year
Date
What is the full address of the Property this lease extension concerns?
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is the new Expiration Date?
-
Month
-
Day
Year
Date
Is the monthly rent changing or remaining the same?
Yes
No
If changing, what is the new monthly rent amount in dollars?
Us Dollar ($)
Is the named person and/or contact information changing or remaining the same?
Yes
No
Named Person's Name:
First Name
Last Name
Named Person's Phone Number:
Please enter a valid phone number.
Format: (000) 000-0000.
Named Person's Email:
example@example.com
Named Person's Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are there any additional amendments to other paragraphs of the lease?
Yes
No
If yes, which paragraph(s) are being amended, and how are they amended?
What is the deadline date by which the Tenant must sign and return this extension to the Landlord?
-
Month
-
Day
Year
Date
If the Tenant does not return the extension by the deadline, will the lease renew on a month-to-month basis?
Yes
No
What will the new monthly rent amount be?
Us Dollar ($)
What is the effective date of this change?
-
Month
-
Day
Year
Date
If the Tenant does not return the extension by the deadline, will the lease terminate instead of renewing?
Yes
No
If yes, what is the termination date by which the Tenant must vacate the Property?
-
Month
-
Day
Year
Date
What is the Landlord’s full name?
On what date will they sign this extension?
*
/
Month
/
Day
Year
Date
Is There More Than One Landlord?
Yes
No
Landlord 2 Signature
On what date will they sign this extension?
/
Month
/
Day
Year
Date
How Many Tenants Are There?
1
2
3
4
Tenant 1 Signature
*
Tenant 2 Signature
On what date will they sign this extension?
/
Month
/
Day
Year
Date
Tenant 3 Signature
On what date will they sign this extension?
/
Month
/
Day
Year
Date
Tenant 4 Signature
On what date will they sign this extension?
/
Month
/
Day
Year
Date
Is this extension being signed by someone under a written property management agreement or power of attorney?
Yes
No
What is the full printed name of the person signing for the Landlord?
What is the firm name?
On what date will they sign?
-
Month
-
Day
Year
Date
Please verify that you are human
*
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