Notice of Failure to Pay Rent

and

Termination of Rental Agreement

TO:

You are hereby notified that you have failed to pay rent when due for the months of	in the amount of $

plus accrued late charges in the sum of $ and late charges accruing at the rate of on the premises commonly known as	Lincoln, Nebraska .

If you fail to pay all past due rentals, together with any applicable late charges, within three (3) days after the date of service of this notice, your Rental Agreement for the occupancy of the premises will be automatically terminated and legal proceedings will be commenced to recover possession of the premises.

This notice shall not constitute a waiver of any other notice issued prior hereto or concurrently with this notice. All prior or concurrent notices shall be cumulative and all rights are hereby reserved to proceed on any or all notices, independently or collectively.

Dated:

By:

Certificate of Service

The undersigned hereby certifies that a true and accurate copy of the above and foregoing was _____mailed first class postage prepaid ______ hand delivered on:

to:

_____________________________

Notice:	All payments must be made with money order or certified funds. Rent and applicable late charges must be delivered to the following address prior to the expiration of the three days at the following address:

{Landlord's name and address for receipt of rent printed below.}

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