Fillable Printable Notice To Pay or Quit Sample Form

Notice To Pay or Quit Sample Form

FIVE-DAY NOTICE TO PAY RENT OR QUIT

TO: ______________________________

TENANT NAME (FIRST AND LAST)

FROM: __________________________

LANDLORD NAME

___________________________________

ADDRESS

__________________________________

ADDRESS

___________________________________

CITY, STATE ZIP CODE

__________________________________

CITY, STATE ZIP CODE

__________________________________

PHONE NUMBER

Date of Service: ______________________

PLEASE TAKE NOTICE that you are in default in payment of rent for the above described premises in the

sum of: $__________________________________ for the period commencing from ____________________

to ____________________. Tenant paid __________________ in adv an ce fo r any cleaning , security or rent

deposits, in excess of the first month’s rent. Rental payment(s) became delinquent on ____________________.

As the tenant of the above described property or premises, you are hereby required to pay the landlord or agent

the amount of rent now in default.

Your failure to pay rent or quit the premises within five (5) days, or your failure to contest this no tice, may result

in the landlord applying to the Justice of the Peace of the Las Vegas Township for an Eviction Order. The

Justice of the Peace may thereupon issue an order directing the Constable to remove you within twenty-four (24)

hours after the receipt of the Eviction Order.

The tenant is hereby advised of his right to contest this Notice by filing, with the Justice of the

Peace of the Las Vegas Township, an Affidavit that he is not in default in the payment of rent.

The Justice of the Peace is located in the Clark County Courthouse. The Affidavit must be filed

with the Court no later than noon on the fifth full day following the date of service.

AFFIDAVIT OF SERVICE

On __________________, I served the above FIVE-DAY Notice to Pay Rent or Quit at the

following time ___: _______ AM / PM and in the following manner:

_______ By delivering a copy to the tenant(s) personally, in the presence of a witness

_______ Because the tenant(s) were absent from their place of residence or from their usual

place of business, by leaving a copy with __________________________, a person of

suitable age and discretion, at either place and mailing a copy to the tenant(s) at their

place of residence or place of business

_______ Because the place of residence or business could not be ascertained, or a person of

suitable age or discretion could not be found there, by posting a copy in a conspicuous

place on the property, delivering a copy to a person there residing, if the person could

be found, and mailing a copy to the tenant(s) at the place where the property is

situated

_____________________ ________________ $_______________ ___

______________________

Server Name (Print) Server Signature Fees paid for service Time and date of request for service

I DECLARE UNDER PENALTY OF PERJURY UNDER THE LAW OF THE STATE OF

NEVADA THAT THE NOTICE WAS PROVIDED ON THE DATE AND IN THE MANN ER

LISTED ABOVE.

_________________________ _______________________

Witness Name (Print) Tenant Signature

_______________________________

Witness Signature