THREE DAY NOTICE TO PAY OR TO VACATE 

Online Court Assistance Program 

his Notice is given to: 

 

 

 

This Notice is given by: 

______________________________ 
Tenant/Occupant Name 

  ______________________________ 

Landlord/Owner Name 

_____________________________ 
Street Address 

_____________________________ 
Street Address 

_____________________________ 
City, State, Zip 

_____________________________ 
City, State, Zip 
 

You are behind in payments required by your rental agreement. You must either pay 
everything you owe or move out within three business days. Business days do not 
include weekend days and legal holidays. Start counting the business days beginning with 
the business day after you receive this notice.  

Move out means leave the property, take all your belongings, and leave any keys or 
access cards. 

You owe: 
 

Rent for these time periods:  

Scan QR code  
to visit page 

         

Total Amount Due 

If you do not pay the total amount due or move out within three business days, the court 
may decide that: 

•  you are in “unlawful detainer” of the property, and 
•  you should be evicted.  

If that happens, you would be removed from the property and may be required to pay all 
amounts due under your rental agreement plus attorney fees, court costs. You could also 
have to pay three times the amount of rent, late fees, and property damage.  

You can find information about the eviction process at:  
utcourts.gov/tenant 

1001EVJ Approved December 18, 
2017 / Revised December 19, 2023 
 

Three Day Notice to Pay or to Vacate 

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Other money owed under the lease: 
(list each item, the amount owed, and when it was due) 

  T

       

       

 

   

$ 

$ 

$ 

Online Court Assistance Program 

Scan QR code  
to visit page 

     

The court’s Finding Legal Help web page (utcourts.gov/help) has 
information about how you can get legal help, including the Self-Help 
Center, reduced-fee attorneys, limited legal help and free legal clinics. 
 

 

Date 

   
    Landlord/Owner Signature ► 

 

 

Printed Name 
 

RETURN OF SERVICE 

 

 

 

This Notice was served upon ______________________________________ (name) on 

______________ (date) in the following manner (check the appropriate boxes): 

  ]  A copy was delivered to the tenant/occupant personally. 

[  ]  A copy was sent through certified or registered mail to the tenant/occupant’s address. 

[  ]  A copy was posted in a conspicuous place on the premises, as no one was home. 

[  ]  A copy was left with __________________ a person of suitable age and discretion at: 

[  ] tenant/occupant’s residence or [  ] tenant/occupant’s place of business  

a second copy was mailed to [  ] tenant/occupant’s residence or [  ] place of 

AND  

business. 

 

Print here _________________________________  

Name of person serving this notice  

Sign here _________________________________ 

Name of person serving this notice 

     

 

 [

 

1001EVJ Approved December 18, 
2017 / Revised December 19, 2023 
 

Three Day Notice to Pay or to Vacate 

Page 2 of 2