Nebraska Three Day Notice To Pay Rent Or Quit

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Name Yes / No and Name

Street address

City , State  ZIP code

YOU ARE HEREBY NOTIFIED that under the lease agreement dated Date under which you hold possession of the premises located at Street address , City , NE, ZIP code , there is now due and unpaid rent in the total amount of $ Amount , representing rent due as follows: 1 / 2 / 3

• $ Amount owed from Date to Date .
• $ Amount owed from Date to Date .
• $ Amount owed from Date to Date .

YOU ARE FURTHER NOTIFIED that in accordance with Neb. Rev. Stat. § 76-1431(2), within THREE (3) days after service of this notice on you, you must pay the above-listed amount in full or leave the premises described above. If you do neither of these, Name will institute legal proceedings against you to recover possession of the premises, to declare the lease agreement forfeited, and to recover rent and damages.

The THREE-DAY notice period expires at: Time am / pm a.m. on Date .

The following forms of payment will be accepted: Cash Cashiers Certified Money Personal Electronic

• Cash
• Cashier's Check
• Certified Check
• Money Order
• Personal Check
• Electronic funds deposit

You may make payments in the following ways: Yes / No

• 1.  Yes / No
• 1.  Yes / No
• 1.   Yes / No
• 1. 

THE LANDLORD RESERVES ALL RIGHTS AND REMEDIES PROVIDED UNDER THE LEASE AGREEMENT AND UNDER APPLICABLE LAWS OF NEBRASKA, INCLUDING DAMAGES FOR UNPAID RENT AND FUTURE LOSS OF RENT UNDER , AND NOTHING IN THIS NOTICE MAY BE CONSTRUED AS A WAIVER OF THOSE RIGHTS AND REMEDIES.

________________________	_______________________________________
Date	Landlord Name

PAGE BREAK HERE

PROOF OF SERVICE

1. At the time of service, I, the undersigned, was at least 18 years of age.

2. I served copies of the fourteen-day notice to pay rent or quit.

3. I served copies of the fourteen-day notice to pay rent or quit to the following tenant:

_________________________________________________________     (Name)

4. The fourteen-day notice to pay rent or quit was served at:

_________________________________________________________    (Full Address)

5. I served the tenant by:

• a. [  ] PERSONAL SERVICE. I personally delivered a copy of the fourteen-day notice to pay rent or quit to the person listed in item 3

on _____________________________ at _______________  am    pm             (Date)                                                 (Time)

• b. [  ] SUBSTITUTED SERVICE BY LEAVING NOTICE & MAILING

				(1) After attempting personal service, I left a copy of the fourteen-day notice to pay rent or quit with
				or in the presence of a person of suitable age and discretion:
				_________________________________________________________________________________ (Insert name of person you left the notice with who is at least 18 years old, or give description (age, sex, height, weight, etc.) if person refuses to give name)
				(2) on _____________________________ at _______________   am    pm                           (Date)                                           (Time)
				(3) I thereafter mailed (by first-class, postage prepaid) a second copy of the fourteen-day notice to
				pay rent or quit to the person listed in item 3 to the address listed in item 4
				on _____________________________ at _______________   am    pm                  (Date)                                           (Time)

• c. [  ] POSTING & MAILING.

				(1) After attempting service, I affixed/posted a copy of the fourteen-day notice to pay rent or quit in a
				conspicuous place at the address listed in item 4
				on _____________________________ at _______________   am    pm              (Date)                                               (Time)
				(2) I thereafter mailed (by first-class, postage prepaid) a second copy of the fourteen-day notice to
				pay rent or quit to the person listed in item 3 to the address listed in item 4
				on _____________________________ at _______________   am    pm                          (Date)                                              (Time)

I declare under penalty of perjury under the laws of the state of Nebraska that the foregoing is true and

correct.

Signed on  _________________________________, at ______________________, Nebraska                        (Date)                                                           (Location)

_____________________________________ Print name of person who served notice	______________________________________ Signature of person who served notice