Date of Notice: [Date]
To (Tenant(s)):
[Tenant Full Name 1]
[Tenant Full Name 2] (if applicable)
Rental Property Address: [Street Address, City, State, ZIP]
1. Past-Due Rent Demand
You are notified that you owe past-due rent in the total amount of $[Amount] for the following period(s):
☐ The amount demanded is rent only.
☐ The amount demanded includes: ☐ late fees ☐ utilities ☐ other charges (describe): [Details] (only if allowed by law/lease).
2. Deadline to Pay or Vacate
You must pay the total amount due or move out and deliver possession of the rental property within 3 days after you receive this notice (or within the time required by applicable law).
3. How to Pay
Payment must be made by: ☐ Cash ☐ Money order ☐ Cashier’s check ☐ Online portal ☐ Other: [Method].
Payment location / instructions: [Address or payment portal details].
Payable to: [Landlord/Property Manager Name].
4. Failure to Comply
If you do not pay the total amount due or move out within the required time, the landlord may start legal proceedings to recover possession of the property and seek rent, damages, and costs as allowed by law.
5. No Waiver
Acceptance of partial payment may be treated as: ☐ Not accepted ☐ Accepted only with a written agreement ☐ As allowed by law. Acceptance of payment does not waive the landlord’s rights unless stated in writing.
Landlord/Agent Name: [Name]
Address: [Address]
Phone: [Phone]
Email: [Email]
7. Proof of Service
I declare that I served this notice on the tenant(s) listed above on [Service Date] by the following method (check one):
☐ Personal delivery to tenant
☐ Delivery to a person of suitable age at the premises and mailing a copy
☐ Posting the notice at the premises and mailing a copy (if allowed)
☐ Other: [Method]
Served by: [Name]
Signature: ___________________________
Signatures
Landlord/Agent: [Name]
Date: [Date]
Signature: ___________________________