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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 , Maine, ZIP Code , there is now due and unpaid rent in the total amount of $ Amount , representing rent due as follows: 1 / 2 / 3
YOU ARE FURTHER NOTIFIED that in accordance with Me. Rev. Stat. Ann. tit. §6002 and §6028, within SEVEN (7) 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, the rental agreement will terminate and Name will institute legal proceedings against you to recover possession of the premises, rent , and damages.
The following forms of payment will be accepted [check all that apply]:
| _____ Cash | _____ Cashier's check | _____ Certified check |
| _____ Money order | _____ Personal check | _____ Electronic funds deposit |
The SEVEN-DAY NOTICE PERIOD expires at: Hour :Minute am / pm a.m. on Date .
You may make payments in the following ways: Yes / No
THE LANDLORD RESERVES ALL RIGHTS AND REMEDIES PROVIDED UNDER THE LEASE AGREEMENT AND UNDER APPLICABLE MAINE LAW, INCLUDING DAMAGES FOR UNPAID RENT, AND NOTHING IN THIS NOTICE MAY BE CONSTRUED AS A WAIVER OF THOSE RIGHTS AND REMEDIES.
| _______________________________________________ Landlord or Landlord's Agent Signature |
| _______________________________________________ Date |
PAGE BREAK HERE
| PROOF OF SERVICE |
| (choose all that apply) |
| [ ] Tenant acknowledges receipt of the 7-day notice to pay rent or quit: | |
| _______________________________________ Date |
_______________________________________ Signature |
| [ ] The 7-day notice to pay rent or quit was personally served on |
| __________________________________ Name |
by the undersigned on | ________________________________. Date |
| [ ] I attempted to make personal service on three different occasions, _______________________. On Name |
| each attempt, I knocked on the door of _________________________________, but no one answered. I Address |
| believed that the tenant was absent, so I securely affixed the 7-day notice to pay rent or quit to the entry |
| door of that address. I also mailed a copy of the notice by first class mail to that address. This was done |
| on _________________________________. Date |
| _______________________________________ Date |
_______________________________________ Signature |