Email
example@example.com
What are the full names of the tenant(s) to whom this notice is addressed?
What is the full address of the property referenced in the lease?
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Which specific paragraph of the lease has the tenant failed to comply with?
By what specific date must the tenant provide written notice to cure the breach?
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
What corrective action must the tenant take to cure the breach of the lease?
What is the detailed reason or description of how the tenant has failed to comply with this paragraph?
What remedies might the landlord pursue if the tenant fails to comply (e.g., termination, damages, legal fees)?
What is the name of the landlord issuing this notice?
What is the date this notice is issued by the landlord?
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
If signed by someone other than the landlord, who is signing on behalf of the landlord under a property management agreement or power of attorney?
What is the printed name of the person signing?
What is the firm name of the person signing (if applicable)?
What is the date of this signature?
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
How is this notice being delivered? (Check all that apply)
Regular US Mail
Certified Mail with Return Receipt Requested
Fax
Hand Delivered
If Other, what is the alternative delivery method?
If Certified Mail is selected, what is the Return Receipt Requested Number?
If Fax is selected, to what number or recipient was it faxed?
If Hand Delivered, to whom was it delivered, and by whom?
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