5 Day Notice Form Page 4
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4ACCEPTANCE OF PARTIAL PAYMENT and NON-WAIVER
AGREEMENT
To:
___________________________________
Owner/Owner’s agent
Re:
___________________________________
Address:
___________________________________
Apt. No.
___________________________________
Date:
___________________________________
I/We acknowledge that rent was due and payable on _______________, and is now in default in
the total amount of $
. I/We ask to pay this amount in the following
manner:
Amount
Date Due:
Comment:
st
$
1
partial payment
I/We understand that the total amount must be paid in full prior to the date of any forcible
detainer hearing now scheduled.
In accordance with A.R.S. § 33-1371, it is hereby understood and agreed that by acceptance of
any partial payment, management does not waive its right under law of the rental agreement.
I/We understand and agree that failure to pay any of the amounts stated herein by the date so
specified shall cause the total amount to become immediately due and payable in full and also
entitle management to continue or immediately commence legal proceedings, through forcible
detainer action, without further demand.
______________________________
Resident
______________________________
Resident
Received this
day of
, 20
.
By: ________________________________________________________
Owner/Owner’s Agent
FD11-105
Revised: 09/02/08
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