HOUSING CHOICE VOUCHER PROGRAM, 1635 WESTERN AVENUE, CINCINNATI, OHIO 45214
Phone: (513) 977-5800 TDD:
TDD:TDD:
TDD: (513) 977-5807 Job Line:
Job Line:Job Line:
Job Line: (513) 97-5659 Website:
Website:Website:
Website: www.cintimha.com
Equal Opportunity Employer, Equal Housing Opportunities
MUTUAL AGREEMENT TO TERMINATE LEASE
We, the undersigned, agree to terminate the contract and agree to the following terms:
• This agreement represents a mutual termination of the Lease.
• This agreement is effective on the last day of the month listed below.
• The tenant and the landlord both understand that no Housing Assistance Payment will be made after
the effective date, even if the tenant remains in the unit.
• Both parties understand that this mutual termination action can not be reversed without the landlord’s
written consent.
• This agreement can be used to waive the required 30-day notice to terminate the lease agreement.
The contract will be terminated ____________________* (must be the last day of the month).
*CMHA reserves the
right to cancel this notice, even if the tenant and landlord agree to break the lease, if the tenant has not been in
the unit 12 months.
Tenant’s Name (Please Print) Landlord’s Name (Please Print)
Tenant’s Signature Landlord’s Signature
Tenant’s Address Landlord’s Address
Tenant’s Phone # Landlord’s Phone #
Date signed Date signed
VOUCHER HOLDER PLEASE NOTE: As of July 1, 2013, if a tenant is paying water and/or sewage at their
current assisted unit, proof that the water bill for the current location must be submitted with the RTA for a new
unit. CMHA will not be able to process the RTA without this documentation.
Please mark only if this item applies to you:
____ I am terminating the lease because I no longer wish to remain on the Housing Choice Voucher program.
FOR OFFICE USE ONLY
Date received by CMHA: ________________ Date mailed to the landlord and tenant: _____________
Reminder: CMHA will make no payments to the landlord after the effective termination date. However, if
you live in this unit after the effective termination date, you and your current Landlord may request in
writing a cancellation of the termination or extension of the termination effective date.
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