解除租赁合同报告 gov

解除租赁合同报告gov一、报告解除租赁合同报告/TerminationofLeaseAgreementReport二、报告编号报告编号：______________________ReportNumber:__________________三、报告日期日期：______________________Date:__________________四、合同双方信息出租方（甲方）：名称：______________________地址：______________________联系电话：__________________法定代表人：________________Landlord(PartyA):Name:________________________Address:________________________Phone:________________________LegalRepresentative:_____________承租方（乙方）：姓名：________________________地址：________________________联系电话：____________________身份证号码：__________________Tenant(PartyB):Name:__________________________Address:_________________________Phone:__________________________IDNumber:_____________________五、租赁合同信息合同编号：ContractNumber:合同签署日期：________年________月________日DateofAgreement:YYYY/MM/DD房屋地址：PropertyAddress:租赁期限：开始日期：__________年________月________日结束日期：__________年________月________日LeaseTerm:StartDate:YYYY/MM/DDEndDate:YYYY/MM/DD六、解除原因解除租赁合同的原因：ReasonforTermination:是否提前通知对方：是/No否/NoNoticeGiven:Yes/NoNo/Yes通知方式：书面通知/WrittenNotice其他方式：________________MethodofNotification:WrittenNoticeOther:________________七、合同解除日期合同解除生效日期：________年________月________日EffectiveDateofTermination:YYYY/MM/DD八、结算与退还租金结算：租金支付情况：_________________租金结算方式：_________________RentSettlement:PaymentStatus:_______________SettlementMethod:______________押金退还：押金金额：______________________退还方式：______________________DepositRefund:Amount:_________________________RefundMethod:__________________九、双方责任与义务出租方（甲方）责任：归还押金：____________________清理房屋：____________________Landlord’sResponsibilities:RefundDeposit:________________CleartheProperty:______________承租方（乙方）责任：清理房屋：____________________归还房屋钥匙：________________Tenant’sResponsibilities:CleartheProperty:______________ReturnKeys:___________________十、争议解决争议解决方式：双方协商解决/Negotiation提交仲裁机构/ArbitrationDisputeResolution:NegotiationArbitration十一、其他条款特别约定：SpecialAgreements:附加条款：附件1：_________________________附件2：_________________________AdditionalTerms:Attachment1:____________________Attachment2:____________________十二、签字出租方（甲方）签字：__________________________日期：__________________________Landlord(PartyA):Signature:________________________Date:____________________________承租方（乙方）签字：______________________