To:_________
[Address]_________,
[City]_________,
[State]_________,
[ZIP Code]_________
Demand is made that you pay the past due rent of $_________, which was due on _________[date]. This amount must be paid to _________[landlord or landlord’s agent] on or before _________[date], or the lease agreement between you and us will be terminated and we will demand that you surrender the premises, as provided in Section _________ of our lease agreement dated _________.
Dated: _________.
____________________________
Signature