Form 4-921 NMRA
Form 4-921. Three-day notice of nonpayment of rent (Mobile Home Park Act).
[Sections 47-10-3 and 47-10-6 NMSA 1978]
THREE-DAY NOTICE OF
NONPAYMENT OF RENT1
(Mobile Home Park Act)
To:
____________________________________________________________________
Address:
____________________________________________________________________
________________________________________, New Mexico _________________
You are notified that you have failed to pay rent as required by the agreement or
separate agreement for a mobile home located in ________________________
County, New Mexico at:
________________________________________ (name of mobile home park)
________________________________________ (mobile home address)
________________________________________ (mobile home lot or space)
________________________________________, New Mexico
______________.
The amount of rent and utilities owed is as follows:
Rent:
$ __________________
Late fee:
$ __________________
Utilities:
$ __________________
Other ________
(explain)
$ __________________
Total due:
$ __________________
If the total shown above is not paid within three (3) days from the date of delivery set out
below, the rental agreement is terminated.
Payment will be accepted only by:
[ ] cash
[ ] money order
[ ] cashiers or certified check
[ ] personal check
Dated this ________ day of ______________, ________.
______________________________________
(owner, manager or agent)
Service of notice2:
[ ] personally delivered to resident
[ ] posted on the mobile home on ______________ (date) and mailed certified mail,
return receipt requested
[ ] Delivered [ ] posted:
Mailed:
Time: __________________
Time: __________________
Date: __________________
Date: __________________
By3: ___________________
By3: ___________________