Affidavit For Default Eviction

STATE OF INDIANA ) ) SS: COUNTY OF HAMILTON ) __________________________ Plaintiff(s) IN THE SUPERIOR COURT NO. 6 OF HAMILTON COUNTY Vs. ___________________________ Defendant(s) CAUSE NO. 29D06-_______-SC-___________ AFFIDAVIT FOR DEFAULT (Eviction) The undersigned states that, to the best of his/her knowledge and belief: 1. The defendant(s), ______________________________________________, was / were legally served with a copy of the Notice of Claim in this case and has / have failed to appear for trial or plead after receiving proper notice. 2. The defendant(s) is / are not under age 18 or otherwise legally incompetent. 3. For purposes of complying with the Servicemembers Civil Relief Act of 2003, 50 U.S.C. App.Sec. 501, I state that: (Check one) ____ (a) Defendant(s) is / are not in the active military service of the United States. ____ (b) I am unable to ascertain whether or not the defendant(s) is / are in the active military service of the United States. 4. The plaintiff(s) rented to the defendant(s) the property located at: ______________________________________________________________, at a rate of $__________ per month payable in advance on the _____ day of each month. 5. The defendant(s) has / have violated the rental agreement with the plaintiff(s) by: ____ (a) Failing to pay rent / late fees / utilities (circle those that apply) currently totaling $__________ and / or ____ (b) _____________________________________________________ _______________________________________________________________ American LegalNet, Inc. www.FormsWorkFlow.com 6. The defendant(s); ____ remain(s) in the property; ____ has / have vacated the property ____ The defendant(s) ___did ___ did not leave property of value on the Premises. 7. Plaintiff(s) hold a security deposit in the amount of $__________. The plaintiff(s) __ has __ have complied __ will comply with the Indiana Security Deposit Act. 8. There are no set-offs or counterclaims in favor of the defendant(s). 9. There is due and owing by the defendant(s) to the plaintiff(s) the following: a) Rent b) Damages c) Utilities d) Interest e) Late fees f) Attorney fees g) Other _______________ TOTAL Court Costs $_______________ $_______________ $_______________ $_______________ $_______________ $_______________ $_______________ $_______________ $_______________ 10. _____ Plaintiff(s) request(s) eviction effective on ______________________. 11. _____ Plaintiff(s) request(s) entry of a money judgment effective this date. OR 12. _____ Plaintiff(s) request(s) that the Court set a damages hearing. I affirm, under the penalties for perjury, that the foregoing representations are true. ____________________ Date Rev. 1/07 Affidavit for Default (Eviction) _______________________________________ Plaintiff / Plaintiff's counsel American LegalNet, Inc. www.FormsWorkFlow.com