Complete Your Custom ORHA Rental Form

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et al (and all others)

This is to inform you that your rent is now at least seven (7) days past due. This is your 10-day written notice to pay your past due rent or your rental agreement will be terminated as provided by Oregon Landlord/Tenant Law.
To Satisfy This Notice, You Must Pay At Least Your Past Due Rent Amount of: 



If you are on a Fixed-term Lease, be advised your Landlord has the option to terminate your tenancy at the End of your Lease if you have received three or more Notices for Noncompliance (including Nonpayment of Rent) within a 12-month period preceding the End of the Fixed-term. Owner/Agent may terminate the tenancy by issuing a 90-Day Notice prior to the Lease End Date, or 90 days prior to the date designated in the notice, whichever is later. Correcting the third or subsequent violation is not a defense to the termination.
This is your
violation in the last 12 months.

Please Note: Signature field must be filled in and signed after printing.

Owner/Agent Signature:   Date:


For Informational Purposes Only:
Late Fee per Written Rental/Lease Agreement:

Actual Damages (costs) incurred by Owner/Agent for permission and service of this Notice:

Other Amounts Owed:

Total Amount Due (not including Rent Amount above):

There may be additional charges due under your Rental Agreement for which you remain responsible. To avoid Termination of your Tenancy for Nonpayment of Rent, you need only pay the Past Due Rent Amount listed above.

Please Note: This form includes a REQUIRED NOTICE regarding updates to Senate Bill 891.

This notice is required by the State of Oregon to be attached to this form through September 30, 2022. The attachment is automatically included for your convienence. A representation of this notice is displayed below.

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PO Box 20862, Keizer, OR 97307
eMail: office@oregonrentalhousing.com