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Forms & Notices

Release of Lease Due to Domestic Violence

Release from Rental Agreement Due to Domestic Violence

Below is a sample Request of Release from Rental Agreement due to Domestic Violence. This notice is used when a tenant or a household member wishes to be released from a lease due to an incident of domestic violence. For more information about being released from a lease due to domestic violence, see Domestic Violence. To use this sample, take out the information between brackets and replace it with information specific to your situation. Use the link below the notice to download a sample form.

To: [Larry Landlord
123 Landlord Lane
Lincoln, NE 68508]

From: [Terry and Theresa Tenant
123 Tenant Trail
Lincoln, NE 68508]

This is to notify you, pursuant to Neb. Rev. Stat. § 76-1431.01, that I/we will vacate the rental property at [123 Tenant Trail, Lincoln, NE 68508] because a household member is a victim of domestic violence and we wish to be released from the rental agreement due to the domestic violence incident. I/we will vacate the property on the date of [10/1/2021] (a date no less than 14 days and no more than 30 days from the date of this notification.

The following household members are to be released from the rental agreement: [Terry Tenant]

Attached is documentation to show I/we have obtained a protection order against the perpetrator of the act of domestic violence and/or certification of domestic violence from a verified third-party domestic violence organization.

[Terry Tenant]                                              [Theresa Tenant]

Dated: [9/10/2021]

Click here to download a sample form as a PDF.

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