and Lessee . Lessee leased from Lessor the premises located at City of , _______________ County, State of _________, by the lease signed , 20 . A copy of the lease agreement is attached hereto and is made part of this agreement. The parties desire to terminate all rights and obligations under the attached lease. Therefore, in consideration of the mutual agreements made and set forth in this document, One Dollar ($1.00) and other good and valuable consideration, the parties agree as follows: The lease executed between the Lessor and Lessee is terminated and canceled and shall be of no further force and effect. LESSEE shall release to the Lessor the right to possession in and to the above described premises on , 20 and does agree that Lessor shall be entitled to retake possession of said premises, and does, upon that date, release and relieve Lessor from further duties and obligations under said lease or any of its terms, except as stated herein. LESSOR declares that all duties and obligations of Lessee under the lease are terminated as of the date possession is surrendered. In addition, Lessor, for him/herself and all heirs, legal representatives and assigns, releases Lessee, his/her heirs and legal representatives from all claims, demands and causes of action that Lessor had, has or may have against Lessee or against the heirs or legal representatives of Lessee based on the lease. LESSOR agrees to reimburse Lessee in the amount of the security deposit, less reasonable deductions for actual damages to the premises done by Lessee, no later than , 20 . Lessor shall also reimburse Lessee, no later than that date $ advance rent paid under the lease.