Complete Your Custom ORHA Rental Form

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Please Note: There are fields to be filled in after printing and the form must be signed and dated


 Required entries are indicated by * 

  • Occupant(s)*:
  • Occupant(s): et al (and all others)
  • Address*: Unit:
  • City: OREGON Zip:

    (If left blank, notice was personally served prior to 11:59 p.m. on date of service)
    (If left blank, notice was posted and mailed prior to 11:59 p.m. on date of service)
  •   MAILED:
    (If left blank, notice was mailed prior to 11:59 p.m. on date of service)

You are hereby notified that by    a.m.   p.m. (or 11:59 p.m. if left blank)
on this date: ,
you must vacate the rental unit, or legal action will be taken to have you removed.

You must vacate the rental unit because the original tenant, with whom there was a written rental agreement prohibiting subleasing, has vacated the rental unit, and you have remained on the property without the consent of Owner/Agent and Owner/Agent has not knowingly accepted rent from you.

Owner/Agent Signature: __________________________ Date: __________________

  • Owner/Agent:
  • Address:
  • City: , State: Zip:
  • Telephone: Email:

Owner/Agent, after 24-hours’ written notice specifying the causes, may take possession in the manner provided in ORS 90 and 105.

If notice is served by mail ONLY, the ending date must include an additional four (4) days to allow for the delivery of notice, including date of mailing. This notice, if mailed, shall be mailed First Class Mail ONLY (not certified, registered, etc.).

Owner/Agent does not waive the right to terminate by simultaneously or subsequently served notices.


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1462 Commercial St. NE, Salem, OR 97301
Phone: 503-364-5468 | Fax: 503-585-8119

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