TO:  and  , Nevada	FROM:  , , Manner of Service:
	[  ] Personal [  ] Substituted/Mailing [  ] Posting/Mailing

PLEASE TAKE NOTICE that you are in default in payment of rent for the above described premises in the sum of  for the period commencing from to . Rental payment(s) became delinquent on .NOTICE IS HEREBY GIVEN that you are in default in payment of rent for the above-described premises. You are required to pay to the landlord or agent all rent now due and delinquent OR surrender the premises at or before 5:30 p.m. on the 5th day following service of this notice. FAILURE TO PAY OR QUIT may result in an eviction order directing the constable to remove you from the premises within twenty-four (24) hours.

Your failure to pay rent, leave the premises, or contest this Notice within five (5) judicial days may result in the landlord applying to the Justice of the Peace of the _______________________ Township for an Eviction Order.Date tenancy commenced: 

If the Justice of the Peace determines that you are guilty of an unlawful detainer, the Justice of the Peace may thereupon issue a summary order to remove you from, or provide for your non-admittance to, the above described premises that directs the constable or sheriff of this county to remove you within 24 hours after receipt of the order.Date rent became DELINQUENT: 

The tenant is hereby advised of his right to contest this Notice by filing, with the Justice of the Peace of the _______________________ Township, an Affidavit stating that he is not in default in the payment of rent.Amount of rent DUE and DELINQUENT:

The tenant may also file an Affidavit requesting relief from the above referenced Justice of the Peace, pursuant to Nevada Revised Statute (NRS) 118A.390, if the landlord has unlawfully removed the tenant from the premises or has excluded the tenant by blocking, or attempting to block, the tenant's entry upon the premises; or if the landlord willfully interrupts or causes or permits the interruption of an essential service required by a the governing rental agreement or chapter 118A of NRS.PURSUANT TO NRS 40.253, THE TENANT IS ADVISED:

The Justice of the Peace is located at _______________________________________________. The Affidavit must be filed with the Court no later than noon on the fifth full judicial day following the date of service. The Affidavit may be accessed at the Nevada Supreme Court Self-Help Center at its website at http://www.nevadajudiciary.us/1. Of the tenant's right to contest this matter by filing, within five (5) judicial days, an affidavit with the Henderson Justice Court, stating that the tenant has tendered payment or is not in default in the payment of rent;

2. That if the court determines that the tenant is guilty of an unlawful detainer, the court may issue a summary order for the removal of the tenant or an order providing for the nonadmittance of the tenant, directing the sheriff or constable of the county to remove the tenant within 24 hours after receipt of the order; and

3. That, pursuant to NRS 118A.390, a tenant may seek relief if a landlord unlawfully removes the tenant from the premises or excludes the tenant by blocking or attempting to block the tenant's entry upon the premises or willfully interrupts or causes or permits the interruption of an essential service required by the rental agreement or chapter 118A of NRS.

THE COURT THAT HAS JURISDICTION IS HENDERSON JUSTICE COURT. THE TENANT MAY CONTEST THIS NOTICE BY FILING BEFORE 5:00 P.M. WITHIN FIVE (5) DAYS AN AFFIDAVIT WITH HENDERSON JUSTICE COURT, 243 WATER STREET, HENDERSON, NEVADA, STATING THAT YOU ARE NOT DELINQUENT IN SAID RENT AND WHY A SUMMARY EVICTION SHOULD NOT BE ISSUED PURSUANT TO NRS 40.253. IF YOU REQUEST A HEARING, THERE WILL BE A $33.00 COURT FILING FEE.

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DECLARATION OF SERVICE

On ______________________________, 20____, at ______________ (time) I served a copy of this Notice on the above-named tenant(s) pursuant to NRS 40.280 in the following manner  (select one):

[ ] by delivering a copy to the tenant(s) personally, in the presence of a witness  (the server, witness, and tenant must all sign a copy of the notice);

[ ] by leaving a copy with __________________________________________, a person of suitable age and discretion at tenant(s)'s place of residence or place of business, and mailing a copy to the tenant(s) and obtaining proof of mailing.

[ ] by posting a copy in a conspicuous place on the door of the leased property and mailing a copy to the tenant(s) at the place where the leased property is situated and obtaining a proof of mailing.

___________________ (date)	____________________________ (type or print witness' name)	____________________________ (witness' signature)
_______________________ Tenants Signature

ORPURSUANT TO NRS 53.045, I DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF NEVADA THAT THE NOTICE WAS PROVIDED ON THE DATE AND IN THE MANNER LISTED ABOVE.
[ ] Because the tenant(s) were absent from their place of residence or from their usual place of business, by leaving a copy with __________________________, a person of suitable age and discretion, at either place and mailing a copy to the tenant(s) at their place of residence or place of business;

OR
[ ] Because the place of residence or business could not be ascertained, or a person of suitable age or discretion could not be found there, by posting a copy in a conspicuous place on the property, delivering a copy to a person there residing, if the person could be found, and mailing a copy to the tenant(s) at the place where the property is situated.

I declare under penalty of perjury under the laws of the State of Nevada that the foregoing is true and correct.

Date:_____________________

__________________________ Signature of Server	___________________________ Signature of WitnessPrinted Name of Server	_____________________________ Signature of Tenant
_________________________ Printed Name of Server	__________________________ Printed Name of Witness