Default Judgment Action Cover Sheet

DEFAULT JUDGMENT ACTION COVER SHEET Anyone seeking a judgment on a collection matter must complete and sign this sheet. The sheet must accompany the pleading. Is suit on file? What amount is requested in the Complaint? Date of Service Who was served, explain substitute service if made? ___________________________________________________ Costs of service Is affidavit of default prepared and filed? Yes No _____________________ Yes No What is the type of debt? Was any partial payment made on the debt? Has the partial payment been credited? Was collateral involved in the transaction? Please state the original value of collateral. Was the collateral repossessed? Was the collateral sold? What proceeds resulted from the sale of the collateral? Have the proceeds been credited against the debt? Are you requesting pre-judgment interest? If yes, you must file Affidavit outlining requested amount and supporting documents. Amount of prejudgment interest requested Rate of interest used to calculate prejudgment interest Date interest starts to run Is this an open account collection? If yes, limited to Ten percent. If yes, interest is limited to ten percent. Was an attorney used in the prosecution of this claim? Are you requesting attorney fees? If so, please state the amount Yes Yes Yes Yes Yes Yes Yes No No No No No No No N/A N/A N/A Yes No Yes Yes Yes No No No The undersigned attorney expressly states under oath that the statutory and procedural requirements of the State of South Dakota have been met, that default judgment is appropriate and authorized under law, that the undersigned is not aware of any defects in the pleading, service, or prosecution of the case that would prohibit the entry of the requested default judgment. Dated ___________________________ _________________________________________ [Attorney's Name] American LegalNet, Inc. www.FormsWorkFlow.com Subscribed and sworn to before me This _____ day of _____________, ______ __________________________________ Notary Public, South Dakota My commission expires: American LegalNet, Inc. www.FormsWorkFlow.com