NOTICE TO QUIT FOR NON-PAYMENT OF RENT
To: ______________________________
(Tenant’s Name)
_____________________________
(Rental Unit Street Address)
_____________________________
(Rental Unit City/State/Zip)
You are hereby notified that you are indebted to me in the sum of $______________ for
the rent and use of the premises at:
____________________________________________________________________,
(rental address including state)
now occupied by you.
I demand payment of the rent or possession of the premises within 3 days (excluding
Saturday, Sunday, and legal holidays) from the date of delivery of this notice, to wit: on
or before the _______________ (day) of __________________________ (month,
year).
If you pay your past-due rent in full before the above date and time, you will not have to
move.
Landlord’s name, address, and phone number:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
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
I mailed a copy to the tenant.
Date: __________________________
Signature of person attempting service:
___________________________________________________________________
Printed Name:
___________________________________________________________________
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