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State Owned Housing. Lease Agreement Instructions. Instructions for Completing the Employee Housing Lease. Please fill in all blanks as indicated.  For Section 3.2, the last blank may be filled in as “Leased Premises.”

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State Owned Housing

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State owned housing

State Owned Housing

Lease Agreement Instructions


Instructions for completing the employee housing lease

Instructions for Completing the Employee Housing Lease

  • Please fill in all blanks as indicated.

  •  For Section 3.2, the last blank may be filled in as “Leased Premises.”

  •  For Section 4.1 please be sure to select the proper housing option (single family residence or dormitory residence) and delete the inapplicable option.

  •  Sign the Lease as indicated on the signature page in blue ink.

  • Your signature must be notarized. Accordingly, you must sign the Lease in the presence of a Notary Public or a Commissioner of the Superior Court. Have the Notary Public or Commissioner of the Superior Court complete the acknowledgement block below your signature. Type or print the Notary Public’s or Commissioner of the Superior Court’s name below the signature; and, if the acknowledger is a Notary Public, please have the seal affixed over his/her signature.

  • You must sign the Lease in front of two (2) witnesses. One of the witnesses may by the Notary Public or the Commissioner of the Superior Court. Have the witnesses print or type their names under their signatures.

  •  Please complete attach all applicable exhibits to the Lease. If an exhibit is not applicable to the Lease, type “Not Applicable” on the exhibit.

  • Please proofread the Lease before it is signed. Make sure that all of the blanks are completed and brackets around blanks are removed. Do not show tracked changes in the final, execution copy.

  • Please forward the signed Lease to Linda Hubeny, DAS/State Employee Housing Program Manager, 18-20 Trinity St., Hartford, CT 06106 for further processing.

  • If you have any questions regarding this procedure, please contact Linda Hubeny at 860.256.2903 ormailto:[email protected]


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LEASE

THIS LEASE (the “Lease”) is entered into by and between the STATE OF CONNECTICUT, hereinafter called the “LESSOR,” acting herein by ______________ , its Commissioner of the Department of Public Works, duly authorized, pursuant to Section 4b-1 of the Connecticut General Statutes, as revised, and _____________________________, hereinafter called the “RESIDENT.”

WITNESSETH:

WHEREAS, the RESIDENT is an employee of the State of Connecticut Department of ______________ (the “Agency”); and

WHEREAS, it is desirable to both the RESIDENT and the LESSOR that the RESIDENT reside in the Leased Premises (as hereinafter defined).

NOW, THEREFORE, for valuable consideration and other mutual promises contained herein, the parties hereto agree as follows:

DPW will complete

Employee Name

Agency Name


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Street Address

City/Town

Date signed by Agency and Resident


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Biweekly rate times (X) 26.1

Found on

Cert. Form

% for living on

State Institutional Grounds

If blank, type in

“Leased Premises”

and remove

brackets


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Select proper housing

option and delete

inapplicable option

Town/City where

property is located


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List occupants


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Lessor responsible

for all Utilities

EXCEPT ones

checked, if applicable

If applicable, both parties need

to initial each“check mark”

Both parties

initial, if applicable


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Resident is responsible

For all Utilities EXCEPT

the ones checked, if applicable

If applicable, both parties need to initial each“check mark”

Both parties

initial, if applicable


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DPW will require

a copy of the policy

after the lease is fully

executed


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Two Witnesses Signatures

Resident’s signature

and date signed

City, County, and Date

Name of Resident

Notary Seal

must be used

Notary Signature


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Agency Name

Signature of authorized

Agency Designee

Name and title of person signing


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If Exhibit is not Applicable

to Lease type “Not Applicable”

on the Exhibit.


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Fill in all information

Place a “check mark” on all that apply

Both parties must initial


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Date of Inspection

Agency Name and

signature of authorized designee

Resident name and

Signature


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Use a “check mark”

on all that apply


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Initial all that apply

Authorized agency designee

and resident signatures and

date signed


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Any ???

  • Contact Linda Hubeny

  • Phone: 860.713-5147

  • Email:[email protected]


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