CNG HA X HI CH NGHA VIT NAM

c lp - T do - Hnh phc

HP NG THU NH
(ton b ngi nh s........ng..................phng..........qun.............)
Hm nay, ngy......thng..........nm........., ti...........................chng
ti k tn di y, nhng ngi t nhn thy c nng lc hnh vi dn s
v t chu trch nhim trc php lut v mi hnh vi ca mnh, gm:
Bn cho thu (1):
ng (B) .............................................................................................................
Sinh ngy .........thng..................nm.................................................................
Chng minh nhn dn s:.do...............................
cp ngy.......thng.......nm.................................................................................
Cng v (chng) l B (ng):.............................................................................
Sinh ngy..........thng..................nm.................................................................
Chng minh nhn dn s:.do...............................
cp ngy.......thng.......nm.................................................................................
C hai ng b cng thng tr ti s:............ng...........................................
phng................................qun....................thnh ph..................................(2)
Bn thu (1):
ng (B) .............................................................................................................
Sinh ngy .........thng..................nm.................................................................
Chng minh nhn dn s:.do...............................
cp ngy.......thng.......nm.................................................................................
Cng v (chng) l B (ng):.............................................................................
Sinh ngy..........thng..................nm.................................................................
Chng minh nhn dn s:.do...............................
cp ngy.......thng.......nm.................................................................................
C hai ng b cng thng tr ti s:............ng...........................................
phng.................................qun....................thnh ph..................................(2
Bng hp ng ny, Bn cho thu ng cho Bn thu thu ton b
ngi nh vi nhng tha thun sau y:

Mu ny c ban hnh km theo Quyt nh s: 58/2004/Q-UB ngy 15/3/2004 ca

y ban nhn dn thnh ph

Mu s: 19/CC-H
IU 1
I TNG CA HP NG
1. i tng ca hp ng ny l ngi nh s: .......ng.......................
phng............................qun....................thnh ph..................................(3),
c thc trng nh sau:
a. Nh :
- Tng din tch s dng:..................................................................m2
- Din tch xy dng:........................................................................m2
- Din tch xy dng ca tng trt:....................................................m2
- Kt cu nh:........................................................................................
- S tng:...............................................................................................
b. t :
- Tha t s:.........................................................................................
- T bn s:......................................................................................
- Din tch:........................................................................................m2
- Hnh thc s dng ring.................................................................m2
c. Cc thc trng khc:...........................................................................(4)
(phn din tch nm ngoi ch quyn; din tch vi phm quy hoch, trong
phn din tch trong l gii)
2. ng.........................................v B......................................................
l ch s hu nh v c quyn s dng t nu trn theo giy chng
nhn quyn s hu nh v quyn s dng t s:
ngy.....thng......nm...........
do........................................................................................ cp (5)
IU 2
GI THU NGI NH
1. Gi thu ngi nh l:...........................................................................
(bng ch:.......................................................................................................).
2. Bn thu tr tin thu nh cho Bn cho thu bng ng Vit Nam
theo nh k ....................... mt ln, vo ngy u tin ca mi nh k.
Vic giao v nhn s tin nu trn do hai bn t thc hin v chu trch
nhim trc php lut.

Mu s: 19/CC-H

IU 3
THI HN THU
Thi hn thu ngi nh nu trn l...........k t ngy....... thng.......nm.........
IU 4
NGHA V V QUYN CA BN CHO THU
1. Bn cho thu c cc ngha v sau y :
- Giao nh cho Bn thu theo ng hp ng;
- Bo m cho ngi thu s dng n nh nh trong thi hn thu;
- Bo dng, sa cha nh theo nh k hoc theo tha thun; nu bn
cho thu khng bo dng, sa cha nh m gy thit hi cho Bn thu, th
phi bi thng;
- To iu kin cho Bn thu s dng thun tin din tch thu;
- Np cc khon thu v nh v t (nu c).
2. Bn cho thu c cc quyn sau y:
- Nhn tin thu nh ng k hn nh tha thun;
- n phng nh ch thc hin hp ng nhng phi bo cho Bn
thu bit trc mt thng v yu cu bi thng thit hi, nu Bn thu c
mt trong cc hnh vi sau y :
+ Khng tr tin thu nh lin tip trong ba thng tr ln m khng
c l do chnh ng;
+ S dng nh khng ng mc ch thu;
+ Lm nh h hng nghim trng;
+ Sa cha, i hoc cho ngi khc thu li ton b hoc mt phn
nh ang thu m khng c s ng ca bn cho thu;
+ Lm mt trt t cng cng nhiu ln v nh hng nghim trng
n sinh hot bnh thng ca nhng ngi xung quanh;
+ Lm nh hng nghim trng n v sinh mi trng;
- Ci to, nng cp nh cho thu khi c Bn thu ng , nhng
khng c gy phin h cho bn thu s dng ch ;
- c ly li nh cho thu khi ht hn hp ng thu.

Mu s: 19/CC-H

IU 5
NGHA V V QUYN CA BN THU
1. Bn thu c cc ngha v sau y :
- S dng nh ng mc ch tha thun;
- Tr tin thu nh ng k hn tha thun;
- Gi gn nh, sa cha nhng h hng do mnh gy ra;
- Tn trng quy tc sinh hot cng cng;
- Tr tin in, nc, in thoi, v sinh v cc chi ph pht sinh khc
trong thi gian thu nh;
- Tr nh cho Bn cho thu theo ng tha thun.
2. Bn thu c cc quyn sau y :
- Nhn nh thu theo ng tho thun;
- c i nh ang thu vi bn thu khc, nu c Bn cho thu
ng bng vn bn;
- c cho thu li nh ang thu, nu c Bn cho thu ng bng
vn bn;
- c tip tc thu theo cc iu kin tha thun vi Bn cho thu,
trong trng hp thay i ch s hu nh;
- c u tin k hp ng thu tip, nu ht hn thu m nh vn
dng cho thu;
- c u tin mua nh ang thu, khi Bn cho thu thng bo v vic
bn ngi nh;
- n phng nh ch hp ng thu nh nhng phi bo cho Bn cho
thu bit trc mt thng v yu cu bi thng thit hi, nu Bn cho thu
c mt trong cc hnh vi sau y:
+ Khng sa cha nh khi cht lng nh gim st nghim trng;
+ Tng gi thu nh bt hp l;
+ Quyn s dng nh b hn ch do li ch ca ngi th ba.
- c thay i cu trc ngi nh nu c Bn cho thu ng bng
vn bn.

Mu s: 19/CC-H

IU 6
TRCH NHIM DO VI PHM HP NG
Trong qu trnh thc hin hp ng m pht sinh tranh chp, cc bn
cng nhau thng lng gii quyt; trong trng hp khng t gii quyt
c, cn phi thc hin bng cch ha gii; nu ha gii khng thnh th
a ra Ta n c thm quyn theo quy nh ca php lut.
IU 7
CC THA THUN KHC
Vic sa i, b sung hoc hy b hp ng ny phi lp thnh vn
bn v phi c cng chng hoc chng thc mi c gi tr thc hin.
(6)

IU 8
CAM KT CA CC BN
Bn cho thu v Bn thu chu trch nhim trc php lut v nhng
li cng cam kt sau y :
1. khai ng s tht v t chu trch nhim v tnh chnh xc ca
nhng thng tin v nhn thn ghi trong hp ng ny.
2. Thc hin ng v y tt c nhng tha thun vi Bn thu
ghi trong hp ng ny; nu bn no vi phm m gy thit hi, th phi bi
thng cho bn kia hoc cho ngi th ba (nu c).
IU 9
IU KHON CUI CNG
1. Hai bn hiu r quyn, ngha v v li ch hp php ca mnh,
ngha v hu qu php l ca vic cng chng (chng thc) ny, sau khi
c nghe li gii thch ca ngi c thm quyn cng chng hoc chng
thc di y.
2. Hai bn t c li hp ng ny
iu khon ghi trong hp ng ny.

(7)

, hiu v ng tt c cc

Mu s: 19/CC-H

3. Hp ng ny c lp thnh 03 bn, mi bn gm c.........trang,

cc bn u ging nhau. Bn cho thu gi 01 bn, Bn thu gi 01 bn v
01 bn lu ti..........................................

BN CHO THU

BN THU

(k v ghi r h v tn)

(k v ghi r h v tn)

CH THCH
(1) - Trong trng hp bn giao kt hp ng l c nhn:
ng (B) ...........................................................................................................
Sinh ngy........thng..................nm.................................................................
Chng minh nhn dn s:.do.............................
cp ngy.......thng.......nm...............................................................................
a ch thng tr:............................................................................................
Nu bn no c t hai ngi tr ln, th ln lt ghi thng tin ca tng
ngi nh trn; nu bn thu l ngi Vit Nam nh c nc ngoi, th
ghi h chiu;
Nu c i din, th ghi h tn, giy t ty thn v t cch ca ngi
i din.
(1)- Trong trng hp bn giao kt hp ng l t chc
Tn t chc:.......................................................................................................
Tn vit tt:........................................................................................................
Tr s ti:..........................................................................................................
Quyt nh thnh lp s .............ngy.........thng......nm.......ca....................
in thoi:.........................................................................................................
i din l ng (B).........................................................................................
Chc v:............................................................................................................
Chng minh nhn dn s:.do.............................
6

Mu s: 19/CC-H
cp ngy.......thng.......nm...............................................................................
Vic i din c thc hin theo.....................................................................
(2) Trong trng hp v chng c a ch thng tr khc nhau, th ghi a
ch thng tr tng ngi v ca c hai ngi;
(3) Trong trng hp ngi nh nng thn th ghi r t xm (p, bn),...;
(4) Ghi cc thc trng khc ca ngi nh (nu c) nh: quyn s dng bt
ng sn lin k ca ch s hu ngi nh theo quy nh ca B lut Dn s
(t iu 278 n iu 283); cc hn ch v kin trc v xy dng theo quy
nh ca c quan nh nc c thm quyn hoc theo tha thun ca cc bn;
(5) Trong trng hp cha c cp Giy chng nhn quyn s hu nh
v quyn s dng t , th ghi giy t chng minh quyn s hu nh, quyn
s dng ca ngi nh ;
(6) Ghi cc tha thun khc ngoi cc tha thun nu;
(7) Trong trng hp ngi yu cu cng chng ngh Cng chng vin
c hp ng, th ghi ngi yu cu cng chng nghe c hp ng.