Notice To Tenant Of Termination Of Tenancy For Nonpayment Of Rent
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1NOTICE TO TENANT
OF TERMINATION OF TENANCY FOR
NONPAYMENT OF RENT
To:
(Tenant)
(Date)
Re:
(Address of rental unit)
(City, State)
You are notified that you owe rent in the amount of $
. (This amount does not include any late fees that you may
also owe. You may not be evicted for non-payment of late fees.)
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: by the
day of
, 20
,at
o’clock.
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.
Date:
Signed:
Print Name:
Print Title:
Landlord’s Record of Service
Instructions:
Serve a copy of this notice on the tenant. Immediately fill out this section to describe how service was accomplished.
Complete all statements that apply. Keep the completed original.
❐ Tenant acknowledges receipt of this notice on the
day of
.
(Tenant’s Signature)
❐ This notice was personally served on
by the undersigned on
.
(Name)
(Date)
❐ I attempted to make personal service on the tenant. I knocked on the door, but no one answered. I believed the tenant was absent,
so I securely affixed the notice to the entry door of the premises.
This was done on the
day of
, 20
at
a.m./p.m.
❐ Tenant was served by registered or certified mail. (I have retained the receipt.)
Date:
Signature:
Print Name:
Keep a copy of this notice.
PUB-30 (7/12)
41
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