(3) The name and contact information of each tenant,
including, if possible, phone number, electronic mail address, and mailing
address;
(4) The monthly rental rate of the dwelling unit;
(5) The current amount of the rent due as of the date
of the notice, after applying all rent paid from all sources;
(6) Whether the landlord or landlord's agent has
applied for rental assistance or been contacted on behalf of the tenant by any
agency providing rental assistance;
(7) That any rental assistance received by the
landlord or landlord's agent has been credited to the tenant's amount due;
(8) That a copy of the fifteen-calendar-day notice
being provided to the tenant is also being provided to the mediation center to
be identified by the landlord and, in accordance with subsection (d), in order
for the mediation center to contact the landlord and tenant to attempt to
schedule a mediation regarding the nonpayment of rent;
(9) That the mediation center will provide proof to
the landlord that the notice was received and provide confirmation of the
scheduled date and time of mediation;
(10) That the landlord or landlord's agent may file an
action for summary possession if the rent due is not paid and if mediation is
not scheduled within fifteen calendar days after the tenant's receipt of the
fifteen-calendar-day notice, regardless of whether the scheduled mediation
session occurs within the fifteen calendar days;