Fill and Sign the Ca 3 Day Form

Notice to Pay Rent – page 1 3-DAY NOTICE TO PAY RENT OR QUIT Code of Civil Procedure Section 1161(2) TO: Tenant(s): [tenant name(s) and address of leased premises] NOTICE IS HEREBY GIVEN that pursuant to the lease/rental agreement under which you hold the possession of the premises described in this notice, there is now due, unpaid and delinquent rent (and - if applicable - other fees/amounts) in the following amounts for the following specified periods: [In this space, describe the amounts of rent and other fees/amounts due, and specify periods (months) for which these amounts are due, and reasons for other fees/amounts due, such as “late fee,” etc.] The TOTAL amount (the which is due, unpaid and delinquent is: $________________ You are further notified that within ____________ [number of days not less than 3] days after service of this notice on you, you must pay the amount of rent stated in this notice in full or quit the premises, move out, and deliver up possession of the premises to the undersigned ____________________________________ [lessor or specify attorney or agent], who is authorized to receive possession of the premises, or the undersigned will institute legal proceedings for unlawful detainer against you to recover possession of the premises or to declare the lease/rental agreement) forfeited and to recover rents and damages. The name, telephone number, and address of the person to whom the rent payment shall be made: ______________________________________________________________________________ __________________________________________________________________ If payment may be made personally, the usual days and hours that person will be available to receive the payment are: __________________________________________________________ If the address does not allow for personal delivery, then it shall be conclusively presumed that upon the mailing of any rent or notice to the owner by the tenant to the name and address provided, the notice or rent is deemed received by the owner on the date posted, if the tenant can show proof of mailing to the name and address provided by the owner. IF AND ONLY IF an account number is given here: _________________________, Tenant’s payment may be made into that numbered account in the following financial i nstitution (which must be within five miles of the rental property), the name and street address of the institution being: ________________________________________________________________________ IF AND ONLY IF an electronic funds transfer procedure has been previously established, the Tenant’s payment may be made pursuant to that procedure. Notice to Pay Rent – page 2 You are further notified that by this notice the undersigned elects to and does declare a forfeiture of the lease/rental agreement if the rent stated in this notice is not paid in full within the above- specified ______ days. [In this space, specify any special notification required by rent control jurisdictions, such as: You are hereby notified that advice regarding this notice to pay or quit is available from the Residential Rent Stabilization and Arbitration Board, etc.] Payment will be accepted only by: cash; money order; cashier’s check / certified check; personal check The _____ day notice period described herein shall expire at: o’clock [a.m./ p.m.], on the day of , 20 . LANDLORD RESERVES ALL RIGHTS AND REMEDIES UNDER THE LEASE AGREEMENT AND UNDER APPLICABLE LAW, INCLUDING BUT NOT LIMITED TO CONTRACTUAL DAMAGES FOR UNPAID RENT, AND NOTHING IN THIS NOTICE SHOULD BE CONSTRUED AS A WAIVER OR RELINQUISHMENT OF SAME. If you have any questions, please call , at . Signed, this the day of , 20 . Signed: Landlord/Lessor, or authorized agent Notice to Pay Rent – page 3 PROOF OF DELIVERY A copy of this Notice was delivered to Tenant: by hand by registered/certified mail at the above address, which is: the place designated by Tenant for receipt of communications; Tenant’s last known place of residence; by posting prominently on the front door of the leased premises. Notice delivered/mailed/posted by: Sign Name Print Name In his/her capacity as: Landlord/Lessor; Manager; Agent. Notice delivered/mailed/posted on: [date]