VIRGINIA 5-DAY NOTICE TO QUIT | NON-PAYMENT

Date: [MM/DD/YYYY]

To: [TENANT NAME(S)]

Rental Premises Street Address: [STREET ADDRESS] City: [CITY] State: Virginia

You are notified that you owe rent in the amount of $[AMOUNT OWED]. This amount does not include any late fees that you may also owe. You may not be evicted for non-payment of late fees.

If you do not pay this rent by the date stated below, which must be at least five (5) business days after the date and time you receive this notice, your tenancy will be terminated, and you will be required to move.

Date: [MM/DD/YYYY] Time: [HH:MM] (☐ AM | ☐ PM)

If you pay your rent in full before the date and time above, you do not have to move.

If you do NOT pay your rent or move by the date and time above, a lawsuit may be filed to evict you.

Landlord / Agent Signature: _____________________________
Printed Name: _____________________________