Date:			[Date agreement made]
Name of parties: 	[Tenant] and [Landlord]
Premises: 		[Address]

End of tenancy and agreed quantum of any arrears debt 
It is agreed that the tenancy at the above mentioned premises is ended on and vacant possession to be given on [date], and as a result of the health and economic crisis caused by COVID-19, the parties agree that [negotiated debt amount, note waiver may be appropriate] amount is owing. 

Payment plan
The parties have agreed for the tenant to repay this amount in the following way:
Payment amount	Date
$[x] on 			[date]
$[y] on 			[date]
$[z] on 			[date]

Bond
The parties also agree that the bond is to be released to the tenant [and only if appropriate] saved for the following amounts:
Cleaning costs: 		$x
Other:			$x

The parties agree that no further amount is owing to the landlord and acknowledges that this debt is owed as a result of the crisis caused by COVID-19.
If at any time the tenant cannot repay the amount outlined, the parties will review this amount and separately come to an agreement about the repayment. Should this occur, the parties also agree to utilise the mediation process offered by the community justice centre to come to a different agreement as to the repayment of the arrears.

Signatures:

Tenant, date:								Landlord, date:
Witnessed by, date: