Five-Day Notice To Pay Rent Or Quit Form

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FIVE-DAY NOTICE TO PAY RENT OR QUIT
TO: ______________________________
FROM: __________________________
TENANT NAME (FIRST AND LAST)
LANDLORD NAME
___________________________________
__________________________________
ADDRESS
ADDRESS
___________________________________
__________________________________
CITY, STATE
ZIP CODE
CITY, STATE
ZIP CODE
__________________________________
PHONE NUMBER
Date of Service: ______________________
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 ____________________. Tenant paid __________________ in advance for any cleaning, security or rent
deposits, in excess of the first month’ s rent. Rental payment(s) became delinquent on ____________________.
As the tenant of the above described property or premises, you are hereby required to pay the landlord or agent
the amount of rent now in default.
Your failure to pay rent or quit the premises within five (5) days, or your failure to contest this notice, may result
in the landlord applying to the Justice of the Peace of the Las Vegas Township for an Eviction Order. The
Justice of the Peace may thereupon issue an order directing the Constable to remove you within twenty-four (24)
hours after the receipt of the Eviction Order.
The tenant is hereby advised of his right to contest this Notice by filing, with the Justice of the
Peace of the Las Vegas Township, an Affidavit that he is not in default in the payment of rent.
The Justice of the Peace is located in the Clark County Courthouse. The Affidavit must be filed
with the Court no later than noon on the fifth full day following the date of service.
AFFIDAVIT OF SERVICE
On __________________, I served the above FIVE-DAY Notice to Pay Rent or Quit
at the
following time ___: _______ AM / PM
and in the following manner:
_______
By delivering a copy to the tenant(s) personally, in the presence of a witness
_______
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
_______
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
_____________________ ________________ $_______________ ___ ______________________
Server Name (Print)
Server Signature
Fees paid for service
Time and date of request for service
I DECLARE UNDER PENALTY OF PERJURY UNDER THE LAW OF THE STATE OF
NEVADA THAT THE NOTICE WAS PROVIDED ON THE DATE AND IN THE MANNER
LISTED ABOVE.
_________________________
_______________________
Witness Name (Print)
Tenant Signature
_______________________________
Witness Signature
EVNOT003
REV 07/2004

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