Louisiana 5-Day Notice to Quit Form _ Non-Payment of Rent
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Louisiana 5-Day Notice to Quit for the Nonpayment of Rent
(In Accordance with CCP 4701)

TO:
___________________________________
(name of tenant)

___________________________________
(address)

___________________________________

This notice terminates your tenancy at the above address pursuant with CCP 4701, Louisiana Statutes
and requires you to vacate the premises described above within five (5) days after this notice has been
served upon you unless you pay the unpaid amount of $___________, which was due on the date this
notice was signed.
The amount due was calculated as follows: _______________________
_______________________
_______________________
Total _______________________

$________________
$________________
$________________
$________________

Dated: ______________________
_____________________________________
Landlord or Agent of Landlord
_____________________________________
(address of landlord)
_____________________________________
___________________________________