Please discard this page before providing the notice to your tenant.

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ALABAMAGEORGIAHAWAIIIOWAINDIANAKANSASMARYLANDMISSOURINEW JERSEYOKLAHOMATENNESSEEWEST VIRGINIAWYOMING 3357101014-DAY NOTICE TO PAY RENT OR QUIT

and
,

As a courtesy, YOU ARE HEREBY NOTIFIED that under the lease agreement dated under which you hold possession of the premises located at , , , , there is now due and unpaid rent in the total amount of , representing rent due as follows: 

• owed from to .
• owed from to .
• owed from to .

YOU ARE FURTHER NOTIFIED that  in accordance with Ala. Code §35-9A-421(b),Haw. Rev. Stat. §521-68,Ind. Code Ann. §32-31-1-6,Iowa Code Ann. §648.3,Kan. Stat. Ann §58-2507,Kan. Stat. Ann §58-2508,Okla. Stat. Ann. tit 41 §131,Tenn. Code Ann. §66-28-505,Wyo. Stat. Ann. §1-21-1003, within THREE (3)FIVE (5)SIX (6)SEVEN (7)TEN (10)FOURTEEN (14)FIVE (5)THIRTY (30)THREE (3)TEN (10)  business days after service of this notice on you, you must pay the above-listed amount in full or leave the premises described above. If you do neither of these,  the rental agreement will terminate and will institute legal proceedings against you to recover possession of the premises, to declare the lease agreement terminated, and to recover rent, and damages.

The following forms of payment will be accepted [check all that apply]:

_____ Cash	_____ Cashier's check	_____ Certified check
_____ Money order	_____ Personal check	_____ Electronic funds deposit

The THREEFIVESIXSEVENTENFOURTEENTHREETEN-DAY NOTICE PERIOD expires at: : a.m.p.m. on .

You may make payments in the following ways: 

• 1. in person, at , , , .  The usual days and hours for rent collection are .
• 1. 2. by mail, to , , , .
• 1. 2. 2. 3. by deposit to account at , a financial institution located at , , , . 
• 1. 2. 2. 2. 3. 3. 3. 4. by electronic funds transfer procedure previously established.

THE LANDLORD RESERVES ALL RIGHTS AND REMEDIES PROVIDED UNDER THE LEASE AGREEMENT AND UNDER APPLICABLE ALABAMAARKANSASGEORGIAHAWAIIIOWAINDIANAKANSASKENTUCKYMARYLANDMISSOURIMISSISSIPPINORTH CAROLINANEW JERSEYOKLAHOMAOREGONPENNSYLVANIASOUTH CAROLINASOUTH DAKOTATENNESSEEWEST VIRGINIAWYOMING LAW, INCLUDING DAMAGES FOR UNPAID RENT, AND NOTHING IN THIS NOTICE MAY BE CONSTRUED AS A WAIVER OF THOSE RIGHTS AND REMEDIES.

_______________________________________________ Landlord or Landlord's Agent Signature
_______________________________________________ Date

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PROOF OF SERVICE
(choose all that apply)

[  ] Tenant acknowledges receipt of the 3357101014-day notice to pay rent or quit:

_______________________________________ Date	_______________________________________ Signature

[  ] The 3357101014-day notice to pay rent or quit was personally served on

__________________________________ Name	by the undersigned on	________________________________. Date

[  ] I attempted to make personal service on  ________________________________. I knocked on the                                                                                         Name
door of ________________________, but no one answered. I believed that the tenant was absent, so                                                 Address
I securely affixed the 3357101014-day notice to pay rent or quit to the entry door of that address.
This was done on _________________________________.                                           Date

[  ] Tenant was served by registered or certified mail.

_______________________________________ Date	_______________________________________ Signature