NOTICE TO QUIT FOR FAILURE TO PAY UTILITIES
To: ______________________________
(Tenant’s Name)
_____________________________
(Rental Unit Street Address)
_____________________________
(Rental Unit City/State/Zip)
You (tenant) owe past-due utilities in the amount of $_________________.
If you pay your past-due utilities full within 3 days of the date you received this
notice, you will not have to move.
If you (tenant) do not pay the amount of past-due utilities indicated above, your tenancy
will be terminated and you will be required to move out of the rental unit. In addition, a
lawsuit may be filed to evict you.
Today’s Date: ______________________________
Signature of party completing this notice:
__________________________________________________________________
Printed Name and Title (i.e. landlord, property manager, etc.):
__________________________________________________________________
Tenant’s Acknowledgement
On _______________ (date) at __________ (time), tenant acknowledged receipt of this
notice.
____________________________________________________________________
Tenant Signature and Date
Certificate of Service
I certify that I personally served this notice on the following person:
_____________________________________________________________________
OR
I attempted to make personal service on the tenant(s) named above but no one
appeared. I believed tenant(s) to be absent, so I left the Notice at the rental unit in a
conspicuous place.
OR
Tenants were served by registered or certified mail.
Date: __________________________
Signature of person attempting service:
___________________________________________________________________
Printed Name:
___________________________________________________________________
click to sign
signature
click to edit