Date: _______(1)__________

TO: (Insert Name and Address of Tenant)

FROM: (Insert Name and Address of Landlord)

Rent in the amount of $__(2)__ was due on _____(3)_______ for the period of ______(4)_________ for the premises which you are currently occupying. Please bring your payment to the address shown below or telephone us immediately. Please disregard this notice if

you have already sent us your remittance.

LANDLORD

______________(5)______________

Phone: _______(6)______________