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REQUEST FOR LEASE TERMINATION AGREEMENT

I. BASIC INFORMATION

Property Name/ Address

*

Tenant Legal Name:

*

Lease Date

*

Current Lease Expiration Date

*

Proposed Termination Date

*

II. TERMINATION CONDITIONS

A. Financial Terms

Is termination contingent upon tenant making a termination payment?

*

Is termination contingent upon tenant making a termination payment?

A

Yes

B

No

Security Deposit amount $

*

Will landlord return the security deposit?

*

If tenant is required to make any payments to third parties (e.g., current tax installment; utility charges, etc.)?

*

If tenant is required to make any payments to third parties (e.g., current tax installment; utility charges, etc.)?

A

Yes

B

No

B. Post-Termination Reconciliation

Will parties reserve post-termination reconciliation rights?

A

Yes

B

No

III. Premises Surrender Requirements

Required condition for premises surrender

*

Required condition for premises surrender

As-is condition

Broom clean

Removal of FF&E only (leave affixed)

Removal of all alterations/improvements (incl affixed)

Restoration to original condition

IV. Tenant's Personal Property

How will tenant's personal property be removed?

*

How will tenant's personal property be removed?

Tenant will remove all property by termination date

Tenant will remove specified items only

Landlord will take ownership of specific items:

Abandoned property

V. Maintenance Obligations

Does tenant need to perform deferred maintenance?

*

Does tenant need to perform deferred maintenance?

A

Yes

B

No

Will landlord inspect before termination?

*

Will landlord inspect before termination?

A

Yes

B

No

VI. Additional Terms

Additional Terms

A

Yes

*

B

No

VII. Ancillary Agreements

Are there any ancillary agreements with this tenant that need to be terminated?

*

Are there any ancillary agreements with this tenant that need to be terminated?

A

Yes

B

No