NOTICE TO LANDLORD

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					DATE STAMP

NOTICE TO LANDLORD

Date:
NAME OF LANDLORD/AUTHORIZED AGENT ADDRESS CITY POSTAL CODE PHONE NO.

I hereby give you notice that I am giving up possession of the premises:
APT./UNIT NO. CITY STREET NO. POSTAL CODE STREET NAME

- EFFECTIVE 1:00 PM On day of ,2004

Forwarding Address: Name of Resident: Reason for Leaving:

Landlord

Resident

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OPS-30B Revised June 2004


				
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