COVID-19: Notice to Landlord of Inability to Pay Rent | Bet Tzedek

COVID-19: Notice to Landlord of Inability to Pay Rent


Download EN-Notice-to-Landlord-of-Inability-to-Pay-Rent.pdf


DATE: —————————————–, 2020


Landlord: ———————————————–

Street Address: —————————————–

City, State, Zip: —————————————–

Email Address: —————————————–

SENT VIA (select all that apply): □ Regular Mail □ Email □ Personal Delivery

I am writing regarding my tenancy at (address)—————————————————— .

I am writing to notify you that I am unable to pay the rent that is (or was) due on the (date) ———–of (month) ———–, 2020, due to reasons, circumstances, and/or financial impacts related to COVID-19. The reasons, circumstances, and/or financial impacts include (select all that apply):

□ I was unable to work because I was sick with, or I was caring for a household or family member who was sick with, COVID-19.

□ I experienced a lay-off, loss of hours, or income reduction resulting from a workplace or business closure or other economic or employment impacts related to COVID-19.

□ Compliance with a government order or recommendation to stay home, self-quarantine, or avoid congregating with others.

□ I incurred child care expenses due to school closures related to COVID-19.

□ I incurred extraordinary health care expenses relating to diagnosis, testing for, and/or treatment of COVID-19 for myself or a household or family member.

□ Other (describe):

Thank you for your understanding and cooperation during these unprecedented times.



(Tenant Name)


(Tenant Signature)


Download the EN-Notice-to-Landlord-of-Inability-to-Pay-Rent.pdf

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