NOTICE TO TENANT OF TERMINATION
To: ______________________________
(Tenant’s Name)
_____________________________
(Rental Unit Street Address)
_____________________________
(Rental Unit City/State/Zip)
You are hereby notified that your rental agreement is terminated on the date of delivery
of this notice, that your occupancy is terminated 30 days following the date of the
delivery of this notice, and that I demand possession of the premises on
_______________ (date).
If you do not vacate the premises by that date, I will ask the court for an order allowing
me to remove you and your belongings from the premises. You are obligated to pay
rent during the 30-day period for any amount that might accrue during that period. Your
rent must be delivered to:
______________________________________________________________________
______________________________________________________________________
(landlord name and address)
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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