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Form #4B : 72-HOUR NOTICE TO PAY OR VACATE

FOR NONPAYMENT OF RENT

WEEK-TO-WEEK TENANCIES

 

Required entries are indicated by blue icons or *

et al (and all others)

This is to inform you that your Rent is now at least five (5) days past due. This is your 72-Hour 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: 
 


 


 


 
 

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

Owner/Agent Signature:   Date:

MAKE PAYMENTS TO:

For Informational Purposes Only:
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.

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