3 Day Pay Or Quit Blank Form

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To:
From:
You are in possession of property which located at
Within three (3) days after service of this notice, you are required to pay the rent now
due and unpaid on the premises at ________________._, a total of
$____________________________________, for rent due for the month(s) of:
__________________________________________________________
or to deliver possession of the premises to
____________________________
Payment shall be made to:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
If your fail to pay the amount demanded, or to deliver possession of the premises
within three (3) days, will cause the declare a forfeiture of your lease agreement, to
recover possession of the premises, and to seek judgment for the rent owed through the
expiration date of this notice, with damages for each day of occupancy after that date,
___________________________________________________________________.
If you fail to fulfill the terms of your credit obligations, a negative credit report may be
submitted to a credit reporting agency. This Notice to Pay Rent or Quit supersedes all
previous Notices to Pay Rent or Quit, if any.
You are further notified that the undersigned elects to declare the forfeiture of the
lease or rental agreement under which you hold possession of the premises, if you fail
to pay the amount of rent demanded above.
Date: _____________ _ _ _ _
_____________________
________________________

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