SAMPLE
Smoke-free Apartment Building Policy

Smoke Free Living

Resident/s agrees to the following conditions of living in the Smoke Free building known as Street #______, City, State, Zip:

1. Resident/s will not use tobacco products at any time while in the residence known as Street #______, City, State, Zip.
2. Resident/s agree that guest/s will not use tobacco products at any time while in the residence known as Street #______, City, State, Zip.
3. Neither Resident/s nor guest/s will use tobacco products within 20 feet of any entrance to the building known as Street #______, City, State, Zip.

Resident/s agrees that in the event that any tobacco product is used in the address known as Street #______, City, State, Zip, he/she will be issued a non-curable 3 Day Notice to vacate the premises.

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Agent for (Name of Apartment Complex)

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Date

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Resident

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Date