General description of case (pick one) :

Pay rent or quit
Thirty day notice
Commercial
Cure breach or quit
Thirty day notice from tenant

Tenants' Names (Over 18, who signed lease, now in possession):

Any of the above in military?

Yes
No

Type of rental agreement:

Written 
Verbal 
Lease
Month-to-Month

Start Date
Original rent $
Rental Increases $
Current rent effective date

Date notice served

Personal

Sub

Post/Mail

Nonpayment of rent (if applicable):

Balance Due $

What month?

Before submitting double-check the names, dates and the precise amount of rent.