The Violation What is the Lease Violation? What is the Lease Violation? Non-Payment of Rent ($)Non-Compliance with the Lease Landlord's Name Enter the Landlord's Name Landlord's Mailing Address This is NOT the Rental Property Address (unless the Landlord and Tenant live together). Enter the Landlord's Mailing Address Street Address Address Line 2 City Please SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington DCWest VirginiaWisconsinWyoming State ZIP Code Landlord's Contact Info Enter the Landlord's Telephone Number (Optional) Enter the Landlord's E-Mail (Optional) The Tenant(s) Enter the Name(s) of the Tenant(s) Property Address Enter the Rental Property Address Street Address Address Line 2 City Please SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington DCWest VirginiaWisconsinWyoming State ZIP Code Lease Start Date When did the Lease begin? Non-Payment of Rent Enter the Amount Due by the Tenant(s) $ This is the amount, including any late fees, that is due to the Landlord upon service of this notice. Enter the Required Payment Method Enter the Required Payment Method CashCertified CheckCheckMoney Order Non-Compliance Write the Non-Compliance committed by the Tenant(s) In other words, how did the Tenant violate the Lease Agreement? (Explain) Option to Fix Is this the 2nd time in the last 6-months that the Tenant has committed the same Violation? Is this the 2nd time in the last 6-months that the Tenant has committed the same Violation? YesNo Does the Landlord wish to Cancel the Lease Agreement between themselves and the Tenant? Does the Landlord wish to Cancel the Lease Agreement between themselves and the Tenant? YesNo Under Nebraska law, if the Tenant has made the same lease violation within a 6-month period the Landlord has the right to cancel the Lease Agreement. If the Landlord decides to cancel, this form will provide fourteen (14) days for them to vacate. Notice Date Enter the Date of This Notice Enter the Date this Notice shall appear to the Tenant(s). Signature Page The sender may choose to electronically sign below or sign after printing the form. Landlord or Agent Signature Clear Please draw your signature. Print Name Next Save Save and finish later
