Boston Housing Authority s1

Boston Housing Authority

52 Chauncy Street

Boston, Massachusetts 02111-02375

USE AND OCCUPANCY AGREEMENT FOR RESIDUAL TENANCY

In consideration for the continued use and occupancy of apartment # (Apt. #), located at (Address), in the (Development name) Development of the Boston Housing Authority ("BHA"), the undersigned Occupant agrees to pay the amount of $ per month to the BHA. This amount is based upon 30% of the Occupant's household's adjusted reported income, as calculated pursuant to normal BHA rules and procedures. This amount shall change if the Occupant's household's income changes. The Occupant is therefore required to report any change of household income to BHA management. All payments for use and occupancy are due on the first day of each month.

As a condition of the BHA allowing the Occupant's continued occupancy of the above unit, the Occupant agrees that the Occupant and his/her household members and guests shall refrain from any criminal and other activity which threatens the health, safety, or right of peaceful enjoyment of other residents or BHA employees.

The Occupant understands and agrees that payment of this amount for use and occupancy does not in any way invest in the Occupant any property rights, legal or otherwise, nor does this payment create a legal tenancy. The BHA may cancel this Agreement at any time, including, but not limited to, (1) if the occupant violates this Agreement or (2) if the basis of the Occupant's request for acceptance as a tenant of the BHA is denied, and the BHA may seek to evict the Occupant in court.

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Housing Manager Occupant

Dated:

Form RT-02

Page 1 of 1

Rev. 2/23/09