Tenancy
Short Fixed-Term
Tenancy Agreement
HOW TO USE THIS AGREEMENT
1. This is a legally binding contract. This agreement is
suitable for a short fixed-term tenancy of 90 days or less,
which will not be extended or renewed to total more than
90 days. The landlord and tenant(s) must agree in writing
before the tenancy commences that the tenancy will end
on the expiry date.
2. All tenancy agreements must be in writing. A separate
form of tenancy agreement for use for a Boarding House
Tenancy is available on our website.
3. This agreement must be completed in full and signed by
the tenant and landlord.
4. The landlord must provide the tenant with a copy of this
agreement prior to the commencement of the tenancy.
5. If the property is a Unit Titles property, a copy of the
mostrecent Body Corporate rules must be aached to
thisagreement.
6. The rights and obligations set out in the Residential
Tenancies Act 1986 are implied in every residential tenancy
agreement (see pages 2, 3 and 4 of this agreement for
abrief outline of some of the key provisions of the
Residential Tenancies Act 1986). However, the following
rules do not apply in the first 90 days of a short fixed-term
tenancy:
›
rules about market rent (the rent is fixed)
›
rules about increasing the rent aer making
improvements to the property
›
rules on giving notice to end the tenancy
7. No terms or conditions added to this agreement are valid
ifthey are contrary to the Residential Tenancies Act 1986.
8. Landlords must include a signed statement with any new
tenancy agreement that covers what insulation a property
has in the ceilings, floors and walls, including where it is,
what type and what condition. This information can be
provided in the healthy homes standards compliance
statement included in this agreement (page 8).
9. From 1 December 2020, most new or renewed tenancy
agreements must also include specific information about
the landlord’s current level of compliance with the healthy
homes standards. For information on when a healthy
homes compliance statement is required, head to this
pageon our website: www.tenancy.govt.nz/healthy-
homes/compliance-statement
10. Landlords must also provide a statement to confirm
theywill comply, or already do comply, with the healthy
homes standards. This statement can be combined with
the healthy homes standards compliance statement,
withone signature.
11. Landlords must include a statement about whether
theproperty is insured, and if so, what the excess is.
Theymust also include a statement informing the tenant
that a copy of their insurance policy is available on request.
12. All rental properties must meet the requirements in
regulations regarding insulation and smoke alarms.
13. Before signing this agreement all parties should carefully
read it and seek information from Tenancy Services if
theyare unclear about what they are agreeing to.
14. The parties must record their full names correctly.
15. If a bond is paid, a Bond Lodgement Form must also
be completed.
16. Bonds must be lodged with Tenancy Services within
23 working days of being paid. This can be done online.
17. Parties to tenancy agreements are subject to the
provisions of the Privacy Act 2020. Any information
provided on this agreement shall not be used or disclosed,
without consent, for any purpose other than the
administration of the tenancy or to pursue legal action.
18. Leing fees can’t be charged to tenants.
19. If there is a problem between the tenant and landlord,
andthey can’t agree, Tenancy Services can help sort
it out. Visit www.tenancy.govt.nz/disputes or call us
forfree information on 0800 836 262.
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MB_TEN_/
www.tenancy.govt.nz
Tenancy
OUTLINE OF THE PROVISIONS OF THE RESIDENTIAL TENANCIES ACT 1986 (RTA)
Please refer to the Residential Tenancies Act 1986 and amendments for the complete provisions.
Tenants and landlords! If you have problems, talk to each other. If you can’t sort it out, talk to us. We can help you sort
itout. Visit www.tenancy.govt.nz/disputes/self-resolution or call us for free information on 0800 TENANCY
(0800836 262)
1. Agreement
› Each party should keep a copy of this tenancy agreement.
› Changes in the particulars of either party must be notified
to the other party within 10 working days.
› This contract may not be enforceable against a tenant
under the age of 18 (a minor). The Contract and Commercial
Law Act 2017 may apply.
2. Contact details
› Each party must provide an email address and mobile
phone number if they have them.
› Each party must supply a physical address for service
in New Zealand where notices and other documents
relating to the tenancy will be accepted by them, or on
their behalf, even aer the tenancy has ended. Tenants
who supply the rental address as their address for service
should update this at the end of the tenancy. Parties may
also supply an additional address for service which can
include a PO Box, email or facsimile.
› If the landlord is going to be out of New Zealand for more
than 21 days and has to appoint an agent, the landlord
must give the tenant the agent’s name, contact address,
mobile phone number (if any), email address (if any) and
address for service.
3. Rent
› Landlords shall not require rent to be paid more than
2 weeks in advance, nor until rent already paid has been
used up.
› 60 days’ wrien notice must be given for rent increases.
› Rent shall not be increased within 12 months of the start
of the tenancy or the last rent increase.
› Also for rent to be increased in a fixed-term tenancy,
it must be stated in the tenancy agreement.
› Receipts must be given immediately if rent is paid in cash.
4. Bond
› A bond is not compulsory, but a landlord may require
a bond of up to 4 weeks’ rent.
› Bonds must be lodged with the Ministry of Business,
Innovation and Employment within 23 working days
ofbeing paid.
› Receipts must be given for bond payments.
› If the property is sold, the landlord’s rights with regard
tothe bond pass to the purchaser of the property.
› The bond covers any damage or loss to the landlord
if the tenant’s obligations are not met, but does not
coverfair wear and tear.
5. Landlord’s responsibilities
› Provide and maintain the premises in a reasonable condition.
› Allow the tenant quiet enjoyment of the premises.
› Comply with all building, health and safety requirements
that apply to the premises.
› Comply with all requirements in respect of smoke alarms
imposed on the landlord by regulations.
› Landlords need to have working smoke alarms installed in
all their residential rental homes. Any replacement alarms
installed aer 1 July 2016 (other than hard-wired systems)
need to have long life baeries and a photoelectric sensor.
› Pay rates and any insurance taken out by the landlord.
› Not seize the tenant’s goods for any reason.
› Inform the tenant if the property is on the market for sale.
› Not interfere with the supply of any services
to the premises.
› If the landlord is in breach of these responsibilities,
the tenant(s) can apply to the Tenancy Tribunal.
› Appoint an agent and notify the tenant and Bond Centre of
the agent’s details whenever leaving New Zealand for more
than 21 consecutive days.
› Inform the tenant of any changes to the information in the
insurance statement within a reasonable time.
6. Tenant’s responsibilities
› Pay the rent on time.
› Keep the premises reasonably clean and tidy, and notify
the landlord as soon as any repairs are needed. You may
not withhold rent if you cannot get repairs done.
› Use the premises principally for residential purposes.
› Pay all electricity, gas, telephone, and metered
water charges.
› Replace baeries in smoke alarms as required.
› Not damage or permit damage to the premises, and to
inform the landlord of any damage.
› Not disturb the neighbours or the landlord’s other tenants.
› Not alter the premises without the landlord’s wrien
consent.
› Not use the property for any unlawful purpose.
› Leave the property clean and tidy, and clear of rubbish
andpossessions at the end of the tenancy.
› At the end of the tenancy, leave all keys and such things
with the landlord. Leave all chaels supplied with the
tenancy.
› If a maximum number of occupants is stated in the
tenancyagreement, not exceed that number.
7. Rights of entry
The landlord shall enter the premises only:
› with the tenant’s consent at the time of entry
› in an emergency
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› for necessary maintenance or repairs, compliance
or preparation for compliance with any requirements
regarding smoke alarms, insulation and healthy homes
standards, from 8 am to 7 pm, aer 24 hours’ notice
› for an inspection of the property or work done by the
tenant, from 8 am to 7 pm aer 48 hours’ notice
› with the tenant’s prior consent, to show the premises
toprospective tenants, purchasers, registered valuer
orreal estate agent doing an appraisal, or other expert
engaged in appraising the premises (consent may not be
unreasonably withheld but reasonable conditions may
beimposed)
› to test for contamination from 8am to 7pm, aer 48 hours’
notice.
8. Subletting and assignment
› If not expressly prohibited by the landlord, the tenant may
sublet or part with possession with the landlord’s prior
wrien consent.
› Consent may not be unreasonably withheld unless
subleing is totally prohibited by this agreement.
› Landlords must consider all requests from tenants to
assign a tenancy and cannot withhold consent
unreasonably.Aprovision in a tenancy agreement
prohibiting assignment is of no effect. These rules do not
apply to a social housing tenancy covered by section 53B(1)
(a) of the Residential Tenancies Act 1986 if assignment is
prohibited under this agreement.
› The tenant(s) must not assign the tenancy without the
prior wrien consent of the landlord.
9. Making changes to the property
› Landlords must consider all requests from tenants for
changes to the rental property, and must not withhold
consent for a minor change (fixture, renovation, alteration,
or addition), but may aach reasonable conditions.
Responses to requests must be provided inwriting
within21 days.
› The tenant(s) must not make any changes without the
prior wrien consent of the landlord.
› The tenant(s) must return the property to a condition
thatis substantially the same as the condition that the
property was in before any minor changes were made.
However, the landlord and tenant may agree to a different
arrangement in relation to the minor change for the end of
the tenancy (for example, that the minor change will
remain in place).
› Please check the www.tenancy.govt.nz website for further
information.
10. Installation of fibre internet connection
Landlords must permit the installation of a fibre internet
connection to the rental property if:
› there is no fibre connection in the premises; and
› it is possible to install a fibre connection in the premises;
and
› the tenant requests a fibre connection; and
› the fibre connection can be installed at no cost to the
landlord (for example, because the cost is covered by the
UFB Initiative).
Under some circumstances a landlord is not required
to permit installation. There are rules for how landlords
must respond to and facilitate requests for installation.
Please check the www.tenancy.govt.nz website for further
information.
11. Locks
Locks can only be changed with the agreement of both
the tenant and the landlord. They should be provided and
maintained in a secure state by the landlord.
12. Insulation
› Landlords must disclose the extent of insulation in
theirproperties in a signed statement as part of any
newtenancy agreement.
› Landlords must provide ceiling and underfloor insulation
that meets minimum standards unless they meet an
exception. In the case of an exception, the landlord must
explain how it applies.
› Landlords must make all reasonable efforts to obtain
the required information. This includes physically looking,
engaging a professional to do an assessment and/or
checking the council building file.
› This information can be included in the healthy homes
standards compliance statement included in this
agreement as a combined statement.
13. Insurance
› Landlords must disclose whether or not the property
isinsured in a statement as part of any new tenancy
agreement, and if so, the excess amount of any relevant
policies. They must also include a statement informing
thetenant that a copy of their insurance policy is available
onrequest.
› Landlords must provide tenants with this insurance
information (if requested within a reasonable timeframe)
and provide updated information within a reasonable
timeframe if insurance information changes, or (where
they are not the insurance holder) within a reasonable
timeframe of becoming aware of the changes.
› If tenants or their guests damage a rental property as a
result of careless behaviour, the tenant is liable for the
costof the damage up to four weeks’ rent or the insurance
excess (if applicable), whichever is lower. Tenants on
income-related rents are liable for the cost of the damage
up to four weeks’ market rent or the insurance excess
(if applicable), whichever is lower.
› Tenants will be liable for the full cost of damage that they or
their guests cause intentionally or that results from an act
or omission that constitutes an imprisonable offence.
14. Healthy Homes Standards
From 1 July 2021, landlords must include a statement inall new
and renewed tenancy agreements, which includes details of
the property’s current level of compliance with the healthy
homes standards. This requirement is provided in regulations
34-39 of the Residential Tenancies (Healthy HomesStandards)
Regulations 2019.
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Tenancy
Landlords must include a statement in the tenancy agreement,
which confirms:
› that on and aer the commencement of the tenancy, the
landlord will comply with the healthy homes standards as
required by section 45(1)(bb) of the Residential Tenancies
Act, or
› that the landlord already complies with the healthy homes
standards as required by section 45(1)(bb) of the
Residential Tenancies Act.
This statement can be combined with the healthy homes
standards compliance statement included in this agreement,
with one signature.
15. Notice to terminate tenancy*
Short fixed-term tenancies
Short fixed-term tenancies expire on the agreed end date and
no notice period to end the tenancy is required. If the tenancy
is extended or renewed beyond 90 days, it automatically
becomes periodic at the end of the fixed-term and becomes
subject to the normal requirements that apply to terminating
a periodic tenancy. Please check www.tenancy.govt.nz/
ending-a-tenancy/ for further information.
Periodic tenancies
Tenants terminating a periodic tenancy must give at least
28days’ written notice. Tenants may end the tenancy for
anyreason, and do not need to give a reason to the landlord.
Landlords are no longer able to terminate a periodic tenancy
without cause (without a reason) by providing 90 days’
written notice.
The landlord may give 63 days’ notice in writing – and must
state the reason for termination if:
› the premises are required as the principal place of
residence for the owner or any member of that owner’s
family, and is to be lived in within 90 days aer the
termination date, for at least 90 days; or
› the landlord customarily uses the premises for occupation by
employees or contractors and the premises are needed for
that purpose (and this is stated in the tenancy agreement).
The landlord may give 90 days’ notice in writing – and must
state the reason for termination if:
› the owner intends to put the premises on the market
within 90 days aer the termination date
› the property has been sold with a requirement by the
owner for vacant possession
› the landlord is not the owner of the property, and the
landlord’s interest is due to end
› the premises need to be vacant to facilitate the use of
nearby land for a business activity (and this is stated
inthetenancy agreement)
› the landlord wants to change the use of the premises
toacommercial use for at least 90 days
› the landlord intends to carry out extensive alterations,
refurbishment, repairs, or redevelopment at the property
within 90 days of the termination date (or material steps
taken) and it would not be reasonably practicable for the
tenant to live there during that process
› the premises are to be demolished within 90 days of the
termination date (or material steps taken).
*This is not an exhaustive list of ways a tenancy may be
terminated.
The tenant can terminate the tenancy with two days’ notice if
the property was an unlawful residential premises at the start
of the tenancy and it is still an unlawful residential premises.
This applies to both fixed term and periodic tenancies.
Family Violence
A tenant who is subjected to family violence during a tenancy
can withdraw from their tenancy by giving at least two days’
notice (with qualifying evidence of family violence) without
financial penalty or the need for agreement from the landlord.
Physical Assault
The landlord can give notice of at least 14 days to terminate
atenancy if the tenant has assaulted the landlord, the owner,
a member of the landlord or owner’s family, or the landlord’s
agent, and evidence is provided that a charge has been filed
byPolice against the tenant in respect of the assault.
16. Termination by Tribunal
The landlord may apply to the Tenancy Tribunal for a
termination order where:
› the rent is 21 days in arrears
› the tenant has caused or threatened to cause substantial
damage to the premises
› the tenant has assaulted, or threatened to assault,
the landlord, a member of the landlord’s family,
or a neighbour
› the tenant has failed to comply with a 14 days’ notice
to remedy a breach
› the premises are unlawful residential premises.
The landlord may apply to the Tenancy Tribunal for a
termination order of a periodic tenancy if:
› the landlord has given the tenant a wrien notices on
three separate occasions for anti-social behaviour within
any 90-day period; or
› the landlord has given the tenant a wrien notice on three
separate occasions when the tenant has missed their rent
payment and this has remained unpaid for at least five
working days within a 90-day period.
The landlord must apply to the Tenancy Tribunal within 28 days
of issuing the third notice. More information is available at
www.tenancy.govt.nz
A tenant may apply to the Tenancy Tribunal for a work order,
compensation or to terminate the tenancy, if the landlord has
breached the tenancy agreement or the Residential Tenancies
Act, or if the property is an unlawful residential premises.
17. Mitigation of loss
If one party to the tenancy agreement breaches it, the other
party must take all reasonable steps to limit the damage or
loss arising from the breach.
18. Unit Title Property
The landlord must notify the tenant of any variations to body
corporate rules affecting the premises.
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LANDLORD DETAILS
Name(s)
This section must be filled in. It is important to give good contact details.
Physical address for service
Email
This email address will be used as an address for services (strike out if not agreed)
(Mobile) (Hm) (Wk)
Phone
Other contact address(es)
Additional address for service
(This may be a PO Box)
If the landlord wishes to include the details of an agent in the agreement, please include the agent’s contact details
on a separate sheet.
TENANT DETAILS
Name(s)
Identification
Driver’s licence Passport Other Write ID Number:
This section must be filled in. It is important to give good contact details.
Physical address for service
Email
(This email will be used as an address for service (strike out if not agreed))
(Mobile) (Hm) (Wk)
Phone
Other contact address(es)
Additional address for service
(This may be a PO Box)
Is any tenant under the age of 18? (Tick one)
Yes No
TENANCY DETAILS
Address of tenancy
Body Corporate rules must be attached if premises are Unit Title premises
(Strike out if not applicable)
Rent per week $ To be paid in advanceFrequency (tick one) weekly fortnightly
Bond amount $
Rent to be paid at
Or into Bank Account No.
Account name
Bank Branch
5
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Tenancy
The landlord and tenant agree that:
1. The tenancy shall commence on the day of 20 .
2. This tenancy is for a short fixed-term, ending on the day of 20 .
› The parties understand and agree that the term of this tenancy will not be extended or renewed to give a total length of more than 90 days. If this tenancy is
extended or renewed so it is in total longer than 90 days, the tenancy will be subject to the normal rules that apply to ending a periodic tenancy at the end of
the fixed-term.
› Both parties are aware that no notice is required to end the short fixed-term tenancy on the expiry date above.
3. Strike out the bold wording below if it is not applicable
The tenant must not sublet the tenancy or part with possession (excluding assignment) without the landlord’s
wrien consent.
Note: The tenant is allowed to assign a tenancy in accordance with the requirements of the Residential Tenancies Act 1986. Assignment may only be prohibited
bya social housing landlord where the tenancy is covered by section 53B(1)(a) of the Residential Tenancies Act 1986. If a social housing landlord wishes to prohibit
assignment they will need to amend this clause accordingly.
4. Insert other terms of this tenancy (eg. pets, maximum number of occupants, reimbursement of recovery costs, right of
renewal if tenancy is a fixed-term)
If necessary, please continue on a separate sheet and attach it to this agreement and ensure that all parties have signed and dated it.
SIGNATURES
Do not sign this agreement unless you understand and agree with everything in it
The landlord and tenant sign here to show that they agree to all the terms and conditions in the tenancy agreement and that each
party has read the notes on pages 2, 3 and 4 of this agreement.
Signed by Date signed
LANDLORD
Signed by Date signed
TENANT
Signed by Date signed
TENANT
6
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Tenancy
INSURANCE STATEMENT
This insurance statement is for landlords, property managers and boarding house managers who can attach it to their
own tenancy agreement.
Law changes relating to insurance and damage
› Landlords are required to disclose whether or not the property is insured in a statement as part ofany new tenancy
agreement, and if so, the excess amount of any relevant policies. Landlords need to include information about insurance
thatis relevant to the tenant’s liability for damage to premises.
› If the rental property is part of a body corporate, landlords will need to include relevant insurance information for both
damage to the rental property itself, and the shared facilities.
› They must also include a statement informing the tenant that acopy of their insurance policy is available on request.
Thisensures that the tenant knows what actions or omissions could invalidate the insurance policy and also helps the
tenantto know what is covered by insurance and the excess payable on the insurance policy.
› Landlords must provide tenants with this insurance information (if requested within a reasonable timeframe) and provide
updated information within a reasonable timeframe if insurance information changes, or (where they are not the insurance
holder) within a reasonable timeframe of becoming aware of the changes.
› If tenants or their guests damage a rental property as a result of careless behaviour, the tenant is liable for the cost of the
damage up to four weeks’ rent or the insurance excess (if applicable), whichever is lower. Tenants on income-related rents are
liable for the cost of the damage up to four weeks’ market rent or the insurance excess (if applicable), whichever is lower.
› Tenants will be liable for the full cost of damage that they or their guests cause intentionally or that results from an act or
omission that constitutes an imprisonable offence.
Insurance statement
Landlords must either complete this form or attach a statement containing the same information.
Address of tenancy
There is insurance covering this rental property that is relevant to tenant’s liability for damage
to premises, including damage to body corporate facilities. Yes No
The table below specifies the excess amounts of all relevant insurance policies for this property.
Name/type of policy Insurer Excess amount
.
.
.
.
The insurance policy for this property is available for the tenant if they request it. This ensures that the tenant knows what
actions or omissions could invalidate the insurance policy and also helps the tenant to know what is covered by insurance and
theexcess payable on the insurance policy.
If these insurance details change and theinformation above or the policy documents are no longer correct, you must provide the
correct information to your tenant within a reasonable time.
7
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Healthy Homes Standards
– current level of compliance
The healthy homes standards apply to short fixed-term tenancies of 90 days or less. However, the compliance deadline for
new tenancies is 1 July 2025, or within 120 days after a tenancy commences, whichever is earlier. If the healthy homes
standards are not complied with during a short fixed-term tenancy of 90 days or less, the landlord will not be penalised if
that tenancy ends before 1 July 2025.
If the short fixed-term tenancy expires before the compliance deadline then the requirement for a landlord to provide a
healthy homes compliance statement is not activated. This should be noted in the tenancy agreement. Landlords must
include in the tenancy agreement an insulation statement and a healthy homes ‘intent to comply’ statement confirming the
landlord’s intent to comply with the healthy homes standards.
If the short fixed-term tenancy lasts longer than 90 days, for example if it is renewed or extended, it will then no longer be a
short fixed-term tenancy and the landlord will have a further 30 days to comply with the healthy homes standards by the
compliance deadline. This is because the 120 day compliance deadline does not reset.
If a short fixed-term tenancy is renewed the landlord must provide the tenant(s) with a completed healthy homes compliance
statement if the tenancy will no longer end before the compliance deadline.
From 1 July 2025 all rental properties must comply with the healthy homes standards. This means all new short fixed-term
tenancies must comply with the healthy homes standards at the time the tenancy commences and landlords must provide a
completed healthy homes compliance statement. www.tenancy.govt.nz/assets/forms-templates/compliance-
statement.pdf
The information that landlords must include is outlined inregulations 34-39 of the Residential Tenancies (Healthy Homes
Standards) Regulations 2019.
Healthy Homes Standards Compliance Statement
8
The Building Act  bans the installation
and/or repair of foil insulation in residential
buildings with existing electrical installations.
Anyone doing so may be liable to a fine of
upto,. Foil insulation which is in
reasonable condition does not need to be
replaced. Existing foil installation which is
damaged (e.g. torn, foil hanging down off the
floor joists or is no longer reflective), must be
replaced with insulation which meets legal
requirements.
Healthy Homes Standards Compliance Statement
INSULATION STATEMENT
Landlords must either complete this form or attach a signed insulation statement containing the same information.
Address of tenancy:
1. Does insulation meet the minimum requirements for ceiling insulation?
1
Yes No
If no, explain what exception applies and which room(s) it applies to (e.g. professional installer cannot access skillion ceiling
above bedroom 2).
2. Does insulation meet the minimum requirements for underfloor insulation?
Yes No
If no, explain what exception applies and which room(s) it applies to (e.g. professional installer cannot access subfloor space
safely).
Ceiling insulation
Location/coverage Complete (all rooms)
Partial (specify areas not insulated):
None
I don’t know as ceiling space is not accessible in the following areas (specify)
Type Segments/Blankets
Loose-fill
Other (specify)
Ceiling space is not accessible
Bulk Insulation value (R-value): or minimum thickness:
Age of ceiling insulation (if known):
Condition
Insulation is in at least a reasonable condition (if not, please explain why):
Underfloor insulation
Location/coverage
Insulation has no gaps other than clearances where required (e.g. around older style downlights and
chimneyflues)
Ceiling space is not accessible
Complete (all rooms)
Partial (specify areas not insulated):
None
I don’t know as underfloor space is not accessible
in the following areas (specify)
1 For guidance on exceptions and requirements, refer to MBIE’s Insulation Requirements – A guide for Landlords: www.tenancy.govt.nz/assets/Uploads/Insulation-requirements.pdf
9
Type Segments/Blankets
Polystyrene
Foil
Bulk Insulation with foil lining
Other (specify)
Underfloor space is not accessible
Bulk Insulation value (R-value):
or minimum thickness (n/a for foil):
Age of underfloor insulation (if known):
Condition Insulation is in at least a reasonable condition (if not, please explain why):
Insulation has no gaps other than clearances where required (e.g. around pipes)
Underfloor space is not accessible
Wall insulation
Location/coverage
Complete (all rooms)
Partial (specify areas not insulated):
None
I don’t know as wall insulation is not accessible
Supplementary
Information
Any other details about the type or condition if known:
Date insulation was last upgraded
or N/A 
Date insulation was professionally assessed or N/A 
Landlord Statement
I/we, (name of landlord(s)) declare
thatthe information contained in this insulation statement is true and correct as at the date of signing and that all reasonable
efforts have been made to obtain information about the location, type and condition of insulation at the premises.
Signed by Date signed
LANDLORD
Healthy Homes Standards Statement
Strike out one option
I/we,
(name of the landlord(s))
willcomply with the healthy homes standards as required by section 45(1)(bb) of the Residential Tenancies Act.
Signed by Date signed
LANDLORD
I/we, (name of the landlord(s))
already comply with the healthy homes standards as required by section 45(1)(bb) of the Residential Tenancies Act.
Signed by Date signed
LANDLORD
Wall insulation is not compulsory.
However, you must provide this
information where it is known.
Healthy Homes Standards Compliance Statement
10
HEALTHY HOMES STANDARDS STATEMENT – RESIDENTIAL TENANCIES
Landlords must either complete this form or attach a healthy homes statement containing the same information from
1 July 2019.
STRIKE OUT ONE OPTION
I/we (name of the landlord(s))
will comply with the healthy homes standards as required by section 45(1)(bb) of the Residential Tenancies Act.
Signature(s) Date signed
I/we (name of the landlord(s))
already comply with the healthy homes standards as required by section 45(1)(bb) of the Residential Tenancies Act.
Signature(s) Date signed
Healthy Homes Standards Compliance Statement
_____________________________________________________________________________
______________________________________________ __________________________________
_____________________________________________________________________________
______________________________________________ __________________________________
11
Tenancy
PROPERTY INSPECTION REPORT
This report is intended to help avoid disputes
This should be used to record the condition of the property at the start of the tenancy.
The landlord and the tenant should fill out this form together, and tick the appropriate box if the condition is acceptable,
or record any damage or defects.
CONDITION ACCEPTABLE?
ROOM AND ITEM LANDLORD TENANTS DAMAGE/DEFECTS
LOUNGE
Wall/Doors
Lights/Power points
Floors/Fl. Coverings
Windows
Blinds/Curtains
KITCHEN/DINING
Wall/Doors
Lights/Power points
Floors/Fl. Coverings
Windows
Blinds/Curtains
Cupboards
Sinks/Benches
Oven
Refrigerator
BATHROOM
Wall/Doors
Lights/Power points
Floors/Fl. Coverings
Windows
Blinds/Curtains
Mirror/Cabinet
Bath
Shower
Wash basin
Toilet (WC)
LAUNDRY
Wall/Doors
Lights/Power points
Floors/Fl. Coverings
Windows
Blinds/Curtains
Washing machine
Wash tub
BEDROOM 1
Wall/Doors
Lights/Power points
Floors/Fl. Coverings
Windows
Blinds/Curtains
BEDROOM 2
Wall/Doors
Lights/Power points
Floors/Fl. Coverings
Windows
Blinds/Curtains
BEDROOM 3
Wall/Doors
Lights/Power points
Floors/Fl. Coverings
Windows
Blinds/Curtains
RTA Residential Tenancy Agreement www.tenancy.govt.nz PAGE 
Tenancy
BEDROOM 4
Wall/Doors
Lights/Power points
Floors/Fl. Coverings
Windows
Blinds/Curtains
GENERAL
Rubbish bins
Locks
Garage/Car port
Grounds
No. keys supplied
Smoke alarms
Landlords must have working smoke alarms installed in all rental premises. These must meet the requirements in the
Residential Tenancies (Smoke Alarms and Insulation) Regulation 2016, set out below. A landlord who fails to comply is
committing an unlawful act and may be liable for a penalty of up to $7,200.
Landlord - please confirm you have met at least these minimum legal requirements before you rent the premises:
There is at least one working smoke alarm in each bedroom or within three metres of each bedroom’s door – this applies
toany room a person might reasonably sleep in.
If there is more than one storey or level, there is at least one working smoke alarm on each storey or level, even if no-one
sleeps there.
If there is a caravan, sleep-out or similar, there is at least one working smoke alarm in it.
None of the smoke alarms has passed the manufacturer’s expiry or recommended replacement date.
All new or replacement smoke alarms, installed from 1 July 2016 onward, are long-life photoelectric smoke alarms withatotal
battery life when installed of at least eight years or a hard-wired smoke alarm system, and meet the product standards in
theResidentialTenancies (Smoke Alarms and Insulation) Regulation 2016.
All the smoke alarms are properly installed by the landlord or their agent in accordance with the manufacturer’s instructions.
All the smoke alarms are working at the start of the tenancy, including having working batteries.
For important details go to www.tenancy.govt.nz/smoke-alarms
List of furniture and chattels
Provided by the landlord
Signatures for Property
Inspection Report
Do not sign unless you agree to all the details in the
Property Inspection Report
Signed by Date signed
LANDLORD
Signed by Date signed
TENANT
Rent and Bond Receipt
Initial rent payment $
Bond $
Total $
To (name)
Water Meter Reading
For use if charging for water
At start of tenancy
Date paid
Signed as received
 TENS /
RTA Residential Tenancy Agreement www.tenancy.govt.nz PAGE 