Required entries are indicated
by blue icons or *
This is to inform you that your Rent is now at least four (4) 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.
If you are a veteran of the armed forces, assistance may be available from a county veterans' service officer
or community action agency. Call the 2-1-1 information service
to learn about resources in your area.
Please Note: Form must be
signed and dated after printing.
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Owner/Agent Signature: |
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Date: |
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For Informational Purposes Only:
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.
If you are a veteran of the armed forces, assistance may be available from a county veterans' service officer
or community action agency. Call the 2-1-1 information service
to learn about resources in your area.
NOTICE RE: EVICTION FOR NONPAYMENT OF RENT
THIS IS AN IMPORTANT NOTICE OF WHERE TO GET HELP IF
YOU
ARE FACING POTENTIAL EVICTION FOR NONPAYMENT
- (Spanish) Este formulario está disponible en español en:
- (Russian) Бланк этого документа можно получить на русском языке в:
- (Vietnamese) Đơn này có bằng tiếng Việt tại:
- (Traditional Chinese) 本表格的繁体中文版在:
- (Korean) 한국어로 번역된 양식은 다음 웹 싸이트에서 찾을 수 있습니다:
You must comply with deadlines identified in a notice of nonpayment or you risk losing your housing
Rental assistance and support services may be available. Dial 2-1-1 or go to www.211info.org.
Find a local service provider at https://www.oregon.gov/ohcs/housing-assistance/pages/emergency-rental-assistance.aspx
Low-income tenants may be able to receive free or low-cost legal advice by contacting a legal aid organization.
Go to https://oregonlawhelp.org to find an office near you. The Oregon
State Bar provides information about legal assistance programs at www.osbar.org/public