19940 Gulf Boulevard, Unit 140
Indian Shores, Florida
19940 Guff Blvd., Indian Shores, FL 33785; Unit 140 *** Telephone # 1-727-596-0838
OCCUPANCY PERIOD:____________ 2:00 P.M. *** THRU___________ 10:00 A.M.
TENANT NAME :
BUSINESS PHONE: HOME PHONE:
RENTAL RATE: $_______ per week TOTAL RENTAL: $_________ due 3 weeks prior
to occupancy. Note: There is additional charge of $25.00 per person per week over 4 persons
(Max. 6). Electricity, utilities and local phone service will be paid by the owner. Long distance
phone service will be charged to the tenant.
SECURITY/RESERVATION DEPOIT: $________
Mail to: Penelope C. Dewell
4307 Woodmere Rd.
Tampa, FL 33609-3843
Please add $25.00 per person per week over 4; (limit 6).
The security/reservations deposit is paid by tenant prior to occupancy for the reservation of the
unit for the time period specified. In consideration thereof, the owner at his discretion will retain
100% of the deposit if the tenant cancels the reservation. The same will be refunded after bills
are received and paid. If any supplies are lost or broken it shall be the responsibility of the
tenant to replace or pay for the same. The tenant will be responsible far damage to common
areas. Please limit smoking to outside of the unit: balconies, etc. Sorry, no pets!
The undersigned have read and agreed to the above terms and conditions prior to occupancy,
and agrees to abide by the property RULES AND REGULATIONS without exception. These are
posted in the elevator and in the kitchen of Unit 140.
If there are any questions regarding this agreement, please contact Penny Dewell at
Please enclose this form with the security deposit.
Date:____________ Tenant Name (print)________________________
Number & names of persons in unit