Property & rentals 31 questions 2 pages About 11 min to fill in

Rent Payment Plan Request Form Template

Give tenants who've fallen behind a clear, respectful way to propose how they'll catch up.

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Rent payment plan request
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What is the rent payment plan request form template?

When a tenant falls behind, both sides usually want the same thing: the arrears cleared and the tenancy kept. What gets in the way is a vague conversation — a promise to "pay something next week" with no figures and nothing in writing. A structured request turns that into a proposal the landlord can actually assess: how much is owed, what happened, what the tenant can pay and when.

This two-page template starts with the tenancy: rental address, landlord or manager, reference, monthly rent and "Total rent owed so far", with help text making clear an estimate is fine. Tenants can say when they first fell behind, upload any notice they've received, and tick what led to the arrears — job loss, reduced hours, illness, an unexpected bill, a benefits delay or a household change.

Page two is the proposal itself. An optional "Amount you can pay now" asks for a date when it's more than zero. "Extra amount per installment, on top of your usual rent", "How often?", "First installment date" and "Arrears cleared by" set out the plan, with a free-text schedule for uneven amounts. Income and household size give context. Answering yes to "Are you receiving rental assistance or help from an agency?" asks for the agency and case number, plus a caseworker's email if the tenant agrees. A signed declaration confirms the plan isn't agreed until the landlord says so in writing. Requests arrive as PDFs in your FileIt vault.

Best for
Landlords, property managers and housing providers
Filled in by
Tenants who are behind on rent
Time to complete
About 8 minutes
Includes
Arrears and reasons, notice upload, lump sum and installments, schedule, income, assistance case details, declaration, signature

Who uses a rent payment plan request form?

  • Responding to a tenant who has missed one or more months
  • A standard route for hardship requests across a rental portfolio
  • Coordinating with an emergency rental assistance program
  • Housing associations recording repayment proposals
  • Small landlords who want proposals in writing
  • Including a link with an arrears reminder letter

Questions on this rent payment plan request form

31 questions over 2 pages · includes signature, file upload, conditional questions, multiple pages, consent checkbox.

1 You and your tenancy

  • Your name*
  • Email*
  • Phone*
  • Rental address*
  • Landlord or property manager
  • Tenant or account reference
  • Monthly rent*
  • Total rent owed so far*
  • When did you first fall behind?
  • Have you received a notice or letter about the arrears?
  • Copy of the notice asked only when it applies
  • What led to the arrears?* Lost my job · Fewer hours or lower pay · Illness or injury · An unexpected bill or expense · A delay or change in benefits · A change in my household
  • Anything else you'd like your landlord to understand?

2 Your proposal

  • Amount you can pay now
  • Date of that payment* asked only when it applies
  • Extra amount per installment, on top of your usual rent*
  • How often?* Weekly · Every two weeks · Monthly, with my rent
  • First installment date*
  • Arrears cleared by
  • Proposed schedule
  • Main household income* Employment · Self-employment · Benefits or pension · No income at the moment
  • Monthly household income after tax
  • People in the household
  • Are you receiving rental assistance or help from an agency?*
  • Agency or program* asked only when it applies
  • Case or reference number* asked only when it applies
  • Caseworker's email asked only when it applies
  • Supporting documents
  • Declaration*
  • Signature*
  • Date*

The rent payment plan request form, page by page

1 You and your tenancy

Name, email, phone and "Rental address" are required, then the landlord or manager and a reference side by side. "Monthly rent" and "Total rent owed so far" are paired. The tenant can give the date they first fell behind and say whether they've had a notice; yes offers an upload for up to two files. "What led to the arrears?" is required and has an Other box, followed by an optional free-text explanation.

2 Your proposal

Any amount entered under "Amount you can pay now" brings up the date of that payment. The installment amount, frequency and first date are required; the clear-by date and detailed schedule are optional. "Main household income", income after tax and household size follow. The rental assistance question reveals "Agency or program", "Case or reference number" and an optional caseworker email. Supporting documents (up to four), a declaration, signature and date finish the request.

Make the template yours

  • Change the currency on the money questions
  • Edit the declaration to match how you confirm agreed plans
  • Add a dropdown of your properties if you manage several
  • Remove the household income questions if you don't need them
  • File requests into a restricted vault folder — they contain financial details
  • Add your accounts team to the notification emails

Tips for a better rent payment plan request form

  • Reply quickly, even if only to say the request is being reviewed
  • Check the arrears figure against your rent ledger before agreeing anything
  • Agree a plan the tenant can actually afford — a broken plan helps no one
  • Talk to the assistance caseworker early; programs often pay faster when the landlord is engaged
  • Confirm any agreed plan in writing and keep it with the tenancy records
  • Check the rules where your property is — some places set requirements for arrears and repayment

Every response becomes a PDF in your vault

Each request is filed as a PDF in the vault folder you choose, with any notice and supporting documents attached, and you're emailed straight away. The tenant can receive a copy of their proposal.

Use the Responses table to see all open requests and export to CSV to compare proposals with what's owed. Your written reply to the tenant is sent separately.

  1. Start from this template. It opens in the FileIt Forms designer — change any question, add pages, set the rules for when questions appear.
  2. Share it. Turn on a public link, or send it to people by email, each with their own link. They don’t need a FileIt account.
  3. Get the answers as PDFs. Each response is saved as a PDF in the vault folder you choose, with uploaded files attached — and listed in a Responses table you can export to CSV.
Use the rent payment plan request template — it’s free

Rent payment plan request form: frequently asked questions

Is this rent payment plan request template free?

Yes. It's a starter template in the Forms app, available on FileIt's free plan.

Does submitting the form create an agreement?

No. It's a request. The declaration says the plan isn't agreed until the landlord confirms it in writing.

What if the tenant can't pay anything now?

The lump-sum question is optional. Leaving it blank skips the payment date, and the tenant goes straight to installments.

Can tenants mention a rental assistance application?

Yes. Answering yes asks for the agency, case number and optionally the caseworker's email.

Can tenants attach evidence?

Yes. They can upload the arrears notice they received and up to four supporting documents.

Do tenants need a FileIt account?

No. Send them the link by email or text, or include it in a letter.

Use this template — free