NOTICE TO QUIT FOR NON-PAYMENT OF RENT
To: ______________________________
(Tenant’s Name)
_____________________________
(Rental Unit Street Address)
_____________________________
(Rental Unit City/State/Zip)
You (tenant) owe past-due rent in the amount of $____________. If you (tenant) do not
pay the amount of past-due rent indicated above by ___________________ (date) at
____________ (time), your tenancy will be terminated and you will be required to move
out of the rental unit. In addition, a lawsuit may be filed against you.
If you pay your past-due rent in full before the above date and time, you will not have to
move.
Rent is payable to the following person, during the following times, at the following
location:
______________________________________________________________________
______________________________________________________________________
Rent is payable to the following account number at the following financial institution,
at the following address:
______________________________________________________________________
______________________________________________________________________
Rent is payable via electronic funds transfer, using the information below:
______________________________________________________________________
Today’s Date: ______________________________
Signature of party completing this notice:
__________________________________________________________________
Printed Name and Title (i.e. landlord, property manager, etc.):
_________________________________________________________________
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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 AND gave a copy to a “suitable” person at the unit (if available) AND
mailed a copy to the tenant.
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 a copy of the notice with someone
of “suitable” age at the rental unit AND mailed a copy to the tenant.
Date: __________________________
Signature of person attempting service:
___________________________________________________________________
Printed Name:
___________________________________________________________________
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