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[Date] [Landlord’s Name] [Landlord’s Address] Re: Notice to Landlord: lights and wiring do not work or are unsafe Dear : [Landlord’s Name] I am your tenant at the following premises: [Address of premises] I am having difficulty with the electrical wiring in my leased premises. The wi ring is not working and/or is unsafe and causing a potential fire hazard. I am experiencing the following problems: [list] I am requesting that you fix these problems immediately. Sincerely, Tenant: ______________________________________ Date: _________________ [signature] Proof of Delivery This Notice delivered to Landlord or Landlord’s authorized agent: [ ] by personal delivery [ ] certified/registered mail, return receipt requested [ ] other form of notice pursuant to Lease Agreement: Signed: ______________________________________ Date: __________________________

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