NHJB-3041-D (07/07/2020)
EVICTION NOTICE
TO:
Tenant Name
Street Address
City, State, Zip Code
You currently rent property located at:
Street Address Apartment # Town/City
from your landlord:
of the City of , in New Hampshire. This notice is to inform you
of your landlord’s intent to evict you and to request that you vacate the premises, on or before
(known as the expiration date).
The reason for this eviction is:
(NOTE: All applicable reasons for eviction may be checked but the above listed expiration date must comply
with the notice requirements set forth in RSA 540:3 II; the time frame for eviction notices may vary depending
upon the reason for eviction.)
Your failure to pay the rent that was due and in arrears when you received the Demand for Rent
that was served on you on . You failed to pay rent due for the rent
period of . You now owe $ in back rent.
(7 day notice is required per RSA 540:3, II; BUT NOTE: if the reason for eviction is non-payment of
rent, the federal Coronavirus Aid, Relief and Economic Security (CARES) Act, Public Law 116-136,
may prohibit your eviction action at this time or require additional notice to the tenant.)
You have a right to avoid this eviction by payment of the full amount due (see above) plus
fifteen dollars ($15.00). Payment must be made before the expiration date (see date above) in
accordance with RSA 540:9. However, you may not avoid an eviction for non-payment of rent
by paying the arrearages plus $15.00 after an Eviction Notice is given more than three (3)
times in any twelve-month period. You may apply for rental assistance at your town/city
welfare office if you are a qualified residential tenant.
Substantial damage done to the rental property as follows:
(RSA 540:2 II (b)) – (7 day notice is required)
Your failure to comply with a material term of the lease as follows:
(RSA 540:2 II (c)) – (30 day notice is required)
Clear Form
EVICTION NOTICE:
(Tenant name)
NHJB-3041-D (07/07/2020)
The following behavior by you or members of your family which adversely affects the health or
safety of the other tenants or the landlord:
(RSA 540:2 II (d)) – (7 day notice is required)
For the following other good cause:
(RSA 540:2 II (e), RSA 540:2 III, RSA 540:2 IV, or RSA 540:2 V) – (30 day notice is required)
For other statutorily authorized cause as follows:
(Identify specific reason and statutory authority – for example RSA 540:2, II(f) regarding lead exposure-hazard
abatements, or RSA 540:2 II(g) regarding preparing a unit for remediation of insects or rodents) – (30 day notice is
required.)
NOTE: This notice is not a court order requiring you to vacate the rental property. However, if you
remain on the premises after the expiration of this notice, your landlord may continue with New
Hampshire’s lawful eviction process: That process would result in you being served by a sheriff with
a summons called a Landlord and Tenant Writ. If served with a Landlord and Tenant Writ, you will
have the right to dispute the reason(s) for the eviction at a hearing before a judge. To do that, you
will have to file a document called an Appearance with the court where the eviction case is filed, no
later than the “return date” listed on the Writ.
Landlord/Agent Name
Street Address
City, State, Zip Code
Date Signature
I certify that on , at am pm,
I gave in hand to left at the last and usual place of abode of
, above named, a true copy of
the above original notice.
Date Signature
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