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Demand Rent 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

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