A

B
1. Your landlord/landlady, 
D

Name (type or print)
Address or description of premises rented (if different from mailing address)

Notice to mobile home owners who rent
land in a mobile home park:
If you have been late on payments on three or 
more  occasions  during  any  12-month  period 
and  the  park  owner  has  given  you  a  written 
demand for possession for nonpayment of rent 
on  each  occasion,  the  park  owner  may  have 
just cause to evict you.

C
 , says that you owe $ 
 

 rent: 

 

  or 

 7 days 

  b. Move out or vacate the premises.

If you do not do one of the above, your landlord/landlady may take you to court to evict you. If you move out or vacate,   

E
2. If you owe this rent, you must do one of the following within 
  a. Pay the rent owed. 
 
  you may still owe rent.
3. If your landlord/landlady takes you to court to evict you and if you have paid the rent, or if you believe there is a good 
 
reason why you do not owe the rent, you will have the opportunity to present the reasons why you believe you should 
  not be evicted.
4. If you believe there is a good reason why you do not owe the rent claimed by your landlord/landlady, you can have a 
 
F

lawyer advise you. Call him or her soon.

from the date this notice was served.

 days  

  
 

 

Date

Address

Signature of owner of premises or agent

City, state, zip                                                                            Telephone no.

G

I certify that on 

Date

CERTIFICATE OF SERVICE

 I served this notice on 

Name

 delivering it personally to the person in possession.
 delivering it on the premises to a member of his/her family or household or an employee of suitable age and 

by   
 
 
      discretion with a request that it be delivered to the person in possession.
 
 
 
 
      electronic service address: 

 first-class mail addressed to the person in possession.
 electronic service to the person in possession (who has consented in writing to such service) at the following 
 . 

 
 

 

                     

 

Signature  

 

 

Court copy (to be copied, if necessary, to attach to the complaint)

STATE OF MICHIGANDEMAND FOR POSSESSIONNONPAYMENT OF RENTLandlord-Tenant                        Approved, SCAOForm DC 100a, Rev. 5/22MCL 600.5714(1)(a), MCL 600.5716, MCL 600.5718, MCL 600.5775(2)(f)Page 1 of 1To:		┌									┐					└									┘Notice to mobile home owners who rent
land in a mobile home park:
If you have been late on payments on three or 
more  occasions  during  any  12-month  period 
and  the  park  owner  has  given  you  a  written 
demand for possession for nonpayment of rent 
on  each  occasion,  the  park  owner  may  have 
just cause to evict you.

1. Your landlord/landlady, 

Name (type or print)
Address or description of premises rented (if different from mailing address)

 , says that you owe $ 
 

 rent: 

 

  or 

 7 days 

  b. Move out or vacate the premises.

If you do not do one of the above, your landlord/landlady may take you to court to evict you. If you move out or vacate,   

2. If you owe this rent, you must do one of the following within 
  a. Pay the rent owed. 
 
  you may still owe rent.
3. If your landlord/landlady takes you to court to evict you and if you have paid the rent, or if you believe there is a good 
 
reason why you do not owe the rent, you will have the opportunity to present the reasons why you believe you should 
  not be evicted.
4. If you believe there is a good reason why you do not owe the rent claimed by your landlord/landlady, you can have a 
 

lawyer advise you. Call him or her soon.

from the date this notice was served.

 days  

  
 

 

Date

Address

Signature of owner of premises or agent

City, state, zip                                                                            Telephone no.

1. Call your own lawyer.

HOW TO GET LEGAL HELP

2. If you do not have an attorney but have money to retain one, you may locate an attorney through the State Bar of  
  Michigan Lawyer Referral Service at 1-800-968-0738 or through a local lawyer referral service. Lawyer referral services 
  should be listed in the yellow pages of your telephone directory or you can find a local lawyer referral service at 
  www.michbar.org.

3. If you do not have an attorney and cannot pay for legal help, you may qualify for assistance through a local legal aid 
  office. Legal aid offices should be listed in the yellow pages of your telephone directory or you can find a local legal aid 
  office at www.michiganlegalhelp.org. If you do not have internet access at home, you can access the internet at your 
 

local library.

Tenant’s copy

STATE OF MICHIGANDEMAND FOR POSSESSIONNONPAYMENT OF RENTLandlord-Tenant                        Approved, SCAOForm DC 100a, Rev. 5/22MCL 600.5714(1)(a), MCL 600.5716, MCL 600.5718, MCL 600.5775(2)(f)Page 1 of 1To:		┌									┐					└									┘