Jefferson County, NY · Jefferson County
Direct Rent Agreement
This agreement sets terms for direct rent payments by the Jefferson County Department of Social Services to a landlord for a tenant receiving public assistance.
At a glance
- Issued by
- City of Jefferson County · Jefferson County, Jefferson County, New York
- Notarization
- Not required: file this form without a notary.
- Official source
- evogov.s3.amazonaws.com
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
The agreement records the premises, landlord, and tenant and sets terms for Department of Social Services rent payments. It explains when payment responsibility ends, the tenant’s obligations to report a move, and how rent differences or overpayments are handled. The landlord, tenant, and a Department worker each have a dated signature line.
Who needs it
A landlord and tenant, with a Jefferson County Department of Social Services worker, use this agreement for direct rent payments.
How to submit it
Submit it to the county department named on the form; check the county website for current contact details.
About notarization
This agreement is signed and dated without a notary; it has signature lines for the Department worker, landlord, and tenant, and no sworn attachment.
How to submit this form
- 1
Download the Agreement
Download the Direct Rent Agreement PDF.
- 2
Complete the Agreement
Fill in the premises, landlord, and tenant information requested on the form.
- 3
Review the Terms
Review the agreement’s terms for direct rent payments and the responsibilities of the parties.
- 4
Sign and Date
Have the Department worker, landlord, and tenant sign and date their lines.
- 5
Submit to the County
Submit it to the county department named on the form; check the county website for current contact details.
Frequently asked questions
- Do I need a notary for the Direct Rent Agreement?
- No. The agreement has signature and date lines for the Department worker, landlord, and tenant, with no notary block or sworn attachment.
- Who signs the Direct Rent Agreement?
- The form provides signature and date lines for a worker for the Jefferson County Department of Social Services, the landlord, and the tenant.
- What does the Direct Rent Agreement cover?
- It sets terms for Department rent payments, including when payments end, the tenant’s responsibility to report a move, rent not covered by direct payments, and overpayments.
- How do I submit the Direct Rent Agreement?
- Submit it to the county department named on the form; check the county website for current contact details.