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.
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 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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