You are notified that you owe rent in the amount of
If you do not pay this rent by the date stated below (which must be at least SEVEN DAYS after the date and time you receive this notice), your tenancy is terminated and you must move.
Date and time by which rent must be paid:
If you pay your rent in full before this date and time, you do not have to move.
If you do not pay your rent or move by this date and time, a lawsuit may be filed to evict you.
|Print Name: _______________________________
|Print Title: _________________________________
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|LANDLORD'S RECORD OF SERVICE
Instructions: Serve a copy of this notice on the tenant. Immediately fill out the following to describe how service was accomplished. Complete all that apply. Keep original for use in filing a lawsuit.
On __________________________ at _______________a.m./p.m.,
|[ ] Tenant acknowledged receipt of this notice. __________________________________
|[ ] I personally served this notice on the following person: __________________________________
|[ ] I attempted to make personal service on the tenants named above. I knocked on the door of the premises,
|and no one answered. I believed tenants were absent, so I securely affixed this Notice to the entry door of the
|[ ] Tenants were served by registered or certified mail. (The return receipt will be retained for use in court.)
|ATTACH TO COMPLAINT IF SUIT IS FILED