CITY OF PHILADELPHIA
FAIR HOUSING COMMISSION
SAMPLE HARDSHIP REPAYMENT AGREEMENT
Tenant: [NAME]
Landlord: [NAME]
FHC Case Number: [#]
MC Number: [IF APPLICABLE]
The parties agree to the following payment plan pursuant to Section 9-809(7) of the
Philadelphia Code:
1. For the months of ________________________ Tenant owes Landlord
$_______________, in past-due rent.
2. Tenant shall pay ongoing monthly rent in the amount of $_______________ to
Landlord, on time and in full by the ________ day of each month beginning in
_______________ until the landlord tenant relationship terminates.
3. In addition to the ongoing monthly rent listed in Paragraph 2, Tenant agrees to
pay the total amount of past-due rent listed in Paragraph 1 according to the
following plan (select 1):
o Tenant shall pay at least 30% of monthly rent amount per month for the
next nine months with the total amount due in Paragraph 1 paid in full by
September 30, 2021; OR
o Tenant shall pay 1/9 of the amount listed in Paragraph 1, per month until
the total amount due in Paragraph 1 is paid in full by September 30, 2021.
4. Tenant agrees to pay the total amount listed in Paragraph 1 according to the
following schedule (select those that apply):
o January 2021 rent by January ____, 2021 plus $ ________ in past-due rent
by January ____, 2021.
o February 2021 rent by February ____, 2021 plus $ _______ in past-due
rent by February ____, 2021.
o March 2021 rent by March ____, 2021 plus $ _______ in past-due rent by
March ____, 2021.
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o April 2021 rent by April ____, 2021 plus $ _______ in past-due rent by
April ____, 2021.
o May 2021 rent by May ____, 2021 plus $ _______ in past-due rent by
May ____, 2021.
o June 2021 rent by June ____, 2021 plus $ _______ in past-due rent by
June ____, 2021.
o July 2021 rent by July ____, 2021 plus $ _______ in past-due rent by July
_____, 2021.
o August 2021 rent by August ____, 2021 plus $ _______ in past due rent
by August ____, 2021.
o September 2021 rent by September ____, 2021 plus $ _______* by
September 30, 2021.
(*Lump sum may be due to bring balance to zero by September 30, 2021)
5. Pursuant to 9-809(7), Landlord may not charge fees, interest, or other charges on
the past-due rent specified in Paragraph 1 of this Hardship Agreement for the term
of the repayment plan set forth in Paragraph 4.
6. Pursuant to Section 9-809(7), Landlord may not proceed to evict Tenant on the
basis of nonpayment of rent unless: 1) Tenant fails to pay ongoing rent in
accordance with Paragraph 2; or 2) Tenant is in arrears of past-due rent payments
in an amount equal to three or more monthly payments (referring to the additional
payments outlined in Paragraph 3).
7. If, at the end of the term of the lease between Tenant and Landlord, Tenant does
not renew or extend the term of the lease and any portion of the past-due rent
specified in Paragraph 1 remains outstanding, Landlord may apply any security
deposit held towards any such past-due rent.
8. This Hardship Repayment Agreement supplements but does not replace any
underlying lease or other agreement between the parties. To the extent the terms
of any other agreement conflict, the terms of this Hardship Agreement shall
prevail.
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9. Pursuant to Section 9-809(7), Landlord shall not require Tenant to reduce this
Hardship Repayment Agreement in a judgment by agreement, consent order,
consent judgment, or similar court order.
10. Landlord agrees that so long as Tenant abides by the payment plan in Paragraph
3, Landlord will not institute any eviction proceedings against Tenant for non-
payment of rent.
________________________ ______________________________
TENANT LANDLORD/AGENT
________________________ ______________________________
TENANT’S EMAIL ADDRESS LANDLORD’S EMAIL ADDRESS
__________________________ ________________________________
TENANT’S REPRESENTATIVE LANDLORD’S REPRESENTATIVE
__________________________ ________________________________
TENANT REPRESENTATIVE’S EMAIL LANDLORD REPRESENTATIVE’S EMAIL
_____________________ _________________________
DATE DATE
Rental Assistance is now available through the City of Philadelphia for tenants and
landlords to apply together. For more information go to: https://phlrentassist.org/
