To _________________________， Lessee：

　　Take notice， that pursuant to the provisions of paragraph ___ of that certain Lease under which you hold possession of the hereinafter described premises， I have elected to terminate said lease as of ___________， 19___；said lease is being terminated [set forth reason for termination]         and you are hereby required to quit and deliver up possession of the premises on or before the above mentioned date.

　　The lease above mentioned is between  ________________，as Lessor， and _____________  ______ as Lessee， is dated _____________ and covers the property commonly known as.

　　DATED：  ___________

　　______________________（LESSOR）