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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?

A
B

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.)?

A
B

B. Post-Termination Reconciliation

Will parties reserve post-termination reconciliation rights?

A
B

III. Premises Surrender Requirements

Required condition for premises surrender

IV. Tenant's Personal Property

How will tenant's personal property be removed?

V. Maintenance Obligations

Does tenant need to perform deferred maintenance?

A
B

Will landlord inspect before termination?

A
B

VI. Additional Terms

Additional Terms
A
B

VII. Ancillary Agreements

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

A
B