Notice To Tenant Of Termination Of Tenancy For Non Payment Of Utilities

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NOTICE TO TENANT
OF TERMINATION OF TENANCY FOR
NONPAYMENT OF UTILITIES
To:
(Tenant)
(Date)
Re:
(Address of rental unit)
(City, State)
You are notified that you have violated your rental agreement by failing to pay utility bills to
in the amount of $
. This delinquency has caused the utility
company to shut off the service to the rental property.
You are notified that your tenancy is therefore terminated FIVE DAYS from the date you receive this notice, which means that you must
move out by the
day of
, 20
, at
o’clock a.m./p.m.
If you deliver to me within THREE DAYS of the day you receive this notice $
, (which is the amount I had to pay to have
the service restored to the unit), and as long as the unit was not damaged due to the discontinuation of service, you may stay and the
tenancy does not terminate.
If this violation occurs again within 6 months, you may not have an opportunity to cure.
If you have not paid this amount or moved out by the
day of
, 20
, at
o’clock a.m./p.m. a
lawsuit may be filed to evict you.
Signed:
(Landlord/Property Manager)
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)
42

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