Notice To Pay Rent Or Quit Premises Form
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1Notice To Pay Rent Or Quit Premises
To:______________________________________________________________________, and to all other occupants in possession.
You and each of you are hereby notified that the rent for the premises herein-after described
List all tenants here
(under “property address”), which you hold and occupy as Tenant under a Lease or Rental Agreement, written
or oral, in __________________________; is past due. Your monthly rent amount is $_____________________.
County
Monthy Rent
Rent due for____________________ . . . . . . . . . $ ______________
Property Address:
Balance Summary
Balance due from prior months . . . . . . . $ ______________
Current Month
Address
Unit or Apt. #
Total rent due . . . . . . . . . . . . . . . . . . . . . . . . . $ ______________
City
State
Zip Code
You are notified and required to pay the same unto the undersigned within _____ days of the date
of service of this Notice upon you, or in the alternative, to vacate and surrender said premises. Your failure to comply
with this Notice within _____ days after receipt hereof will result in your being in unlawful detainer of the
premises described and subject to judicial proceedings to cause you to be evicted from the premises.
Note: Payment must be by cash or certi�ied funds.
Owner / Agent:______________________________________
Date: ____/____/________
________________________________________
Owner / Agent
Address where rent is to be paid:
________________________________________
Address
Unit or Apt. #
________________________________________
City
State
Zip Code
Declaration
I, the undersigned, say: I am over the age of 18 years. I served this document on ____/____/________, at _________
a.m. / p.m.
Date
Time
in the following manner:
[ ] personal service upon _____________________________________________leaving _____ copy(s).
[ ] by knocking on the door and after there was no answer, posting _____ copy(s) in a conspicuous place on the premises and
mailing a copy to each party named on the ____Day Notice. This Notice was mailed in _________________ County.
County
[ ] by leaving _____ copy(s) with ___________________________________ at the premises and by mailing a copy to each
party named on the _____ Day Notice. This Notice was mailed in __________________ County.
County
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct.
Signed this ____/____/________ at _______________________, WA ____________________________________
Date
City
Server Signature
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