To: _____________________________________

Address: ________________________________

________________________________

________________________________

It is hereby agreed that the current lease on the above referenced property will be extended for a ________ month period.

The new expiration date will be___________________.

The following rates are adjusted at the commencement of the renewed lease term effective _______________________.

Amount Adjusted Total Monthly Amount Due

Rental Rate

acknowledges receipt of

DATED this _________________day of _________________, 20_______ .

(date) (month) (year)

RHA recommends owner/agent re-provide any federal, state or city documents previously required at signing of original

lease to tenant.

Tenant acknowledges receipt of following forms as checked by Owner/Agent (initial):

______________________________________ ______________________________________

Owner/Agent Resident

______________________________________

Resident

_______ Department of Health mold hand out. (required as of July 24, 2005)

_______ EPA Brochure: Protect Your Family from Lead in Your Home (mandatory for pre-1978 Properties)

_______ Disclosure of Information on Lead Based Paint and/or Lead Based Paint Hazards (mandatory for pre-1978 Properties)

_______ DPD Owner-Resident Law Summaries & Attorney General’s Landlord-Tenant Summaries (mandatory for Seattle Properties)

_______ Snohomish County Smoke Detector Certification Addendum (required for single-family properties in Snohomish County)

Resident Names(s) _________________________________________________________________________________

Unit Number _______________ Street Address ___________________________________________________________

City ________________________________________________ State __________________ Zip ___________________

Formal legal advice and review is recommended prior to selection and use of provided form. RHA does not represent your selection or execution of this form as appropriate for your specific circumstances