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FORM 64.

Contract for Housekeeping Services

This Contract for Housekeeping Services, is made by and between (Name of

Individual or business "Employer", located at: _____ ) and (Name of Individual or
business "Employee", located at: _____ ) on (specify date).

WHEREAS, the parties desire that Employee provide housekeeping services for
the following family (or individual) located at (specify name and address); and
WHEREAS, Employee accepts such responsibilities and agrees to perform such
duties as specified herein;


1. This Agreement will commence on (specify date).

2. The Employee agrees to render the following duties: (specify in detail,
such as housecleaning, ironing and laundry duties, shopping, cooking, gardening
work, bathing the children, errands for the family, assisting in transportation
duties, baby-sitting, tending bar at parties, special cleaning instructions,
3. Set forth other pertinent conditions, such as term of the contract,
whether it can be extended after the initial term, living arrangements for the
Employee, reporting hours, and what tools or supplies will be supplied by Employer
or Employee. (For example, Employer will provide all housecleaning supplies and
equipment, with the exception of: specify.)
4. Specify payment. This should include the hourly or weekly rate, and
what taxes will be deducted from the Employee's regular paycheck. (For example:
The Employee will be paid a weekly salary of $X. The following deductions will be
taken to comply with appropriate law including Social Security; federal, state,
and local employment taxes; workers' compensation and unemployment insurance;
charges for personal telephone calls; and other deductions discussed and mutually
approved by the Employee in advance. Said payment will be made each Monday by
5:00 p.m. (Author's Note: Consult your local or state law regarding overtime and
maximum weekly working hour requirements.)
5. The Employee will receive the following benefits: (specify, such as room
and board, meals, sick leave, vacation days, personal days, holidays, health
insurance, life insurance, transportation, or use of an auto).
6. Termination. The Employee is hired AT WILL. Either party can terminate
this Agreement at any time with or without warning, notice, or cause.
7. Severance Pay. At the termination of this Agreement, Employee shall
receive X week's severance pay plus all accrued wages and benefits earned up to
the termination date.
8. This Agreement supersedes all prior agreements and understandings and
may only be modified in writing and signed by both parties. This Agreement is in
force when signed below.
9. This Agreement cannot be assigned without the prior consent of Employer.
10. This Agreement shall be governed by the law of the state of (specify).

Name of Employer
Dated: _________________
Name of Employee