Fill and Sign the Rent Past Due Form

Promissory Note for Past Due Rent The undersigned hereby agree that as of _____________________ (date) , the sum of $____________ is owed for past due Rent to ______________________ (Name of Landlord) , a corporation organized and existing under the laws of the state of ______________, with its principal office located at ________________________________________________________ ________________ (street address, city, county, state, zip code) , referred to herein as the Landlord , by ___________________ (Name of Tenant) of ____________________________ _____________________________________ (street address, city, county, state, zip code) , referred to herein as Tenant . This Rent is owed pursuant to that certain Lease Agreement between Landlord and Tenant covering the Mobile Home located at ________________________________________ __________________________________ (street address, city, county, state, zip code) . The said Rent and interest in the amount of ______% per annum shall be payable at ____________________________________________________________________________ (street address, city, county, state, zip code) , or at such other place as the holder hereof may designate in writing, in _____consecutive monthly installments of $__________. The first of said installments shall be due and payable on the ____________________ (date) , and each subsequent monthly installment shall be due and payable on the first day of each succeeding month thereafter until the entire indebtedness evidenced by this Note is fully paid, except any remaining indebtedness, if not sooner paid, shall be due and payable on __________________ (date) . It is agreed that in the event default is made in the payment of this Note at maturity, or of any installment thereof, whether maturing by expiration of time, by default as herein provided, or as provided in the Deed of Trust given in security hereof, and the same is placed in the hands of an attorney for collection, then an additional amount of Ten Percent (10%) on the principal and interest of this Note shall be added to the same as a collection fee, and the failure to pay any installment when due shall mature the entire indebtedness at the option of the holder of this Note. WITNESS OUR SIGNATURES, as of the day and date first above named. _____________________________ Signature of Maker of Note Signature of Maker of Note