Date ________________
To Tenant(s) _________________________________________________________________________
Items left blank or unchecked are not applicable.
Facts:
1. You are a residential Tenant(s) under a rental agreement or expired lease agreement
A. dated ___________ in city of __________________, and county of __________________, California,
B. entered into by ____________________________________________________, as the Tenant(s), and
C. _______________________________________________________________, as the Landlord/Agent,
D. regarding the rental unit with the address of _______________________________________________
__________________________________________________________________________________.
Notice:
2. This notice is intended as at least a thirty (30) day notice prior to termination of your month-to-month
tenancy.
3. On or before _____________, 20______, a date at least thirty (30) days after service of this notice, you
will vacate and deliver possession of the premises to Landlord/Agent, or___________________________
____________________________________________________________________________________.
4. Rent due prior to the date to vacate includes pro rated rent of $_______________, payable on or before
____________, 20______.
5. Landlord/Agent acknowledges the prior receipt of $_______________ as your security deposit.
A. Notice: You have the right to request and be present for an inspection of the premises to be conducted
within two weeks of expiration of this notice to vacate for the purposes of providing you with an
itemized statement of deductible charges for repairs and cleaning and allowing you the opportunity to
remedy these deficiencies and avoid a deduction from your security deposit. [Calif. Civil Code
§1950.5(f)(1)]
B. Within 21 days after you vacate, Landlord/Agent will furnish you with a written statement and
explanation of any deductions from the deposit and a refund of the remaining amount. [Calif. Civil
Code §1950.5(g)(1)]
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