On or before_________________,
I promise to pay you $___________ for rent and other charges on the dwelling
which I rent from you located at ___________________________.
I expect to be receiving sufficient funds to pay you from the following sources:
Name ____________________________
Address__________________________________
Phone____________________________
Amount expected_________________________
Should you wish to, you have my authorization to verify these sources.
If I fail to honor this pledge, I understand that I will be evicted and that this pledge will be used against me as evidence of my bad faith in paying what I owe.
________I acknowledge receipt of a Notice to Pay Rent or Quit as required by law to begin eviction proceedings. I understand that the Notice may show a balance owed which is different from that given above because a Notice to Pay Rent or Quit can demand only delinquent rent. I also understand that the period mentioned in this Notice is being extended to the date given above, at which time I promise to pay you what I owe. If I fail to pay on or before that date, you have the right to continue legal eviction procedure against me without having to serve me another Notice to Pay Rent or Quit. I have already been served. I am being given the extra time to pay only as a courtesy and only this once.
Signed____________________________
Dated________________________
