Affidavit-Default Judgment {SCA-M429-2}

IN THE MAGISTRATE COURT OF COUNTY, WEST VIRGINIA Plaintiff v. Case No. Defendant AFFIDAVIT: DEFAULT JUDGMENT STATE OF WEST VIRGINIA COUNTY OF , TO - WIT: This day appeared before me, and on his or her oath or affirmation says: 1. I am the plaintiff in the above - styled action against the defendant . 2. That on the day of , the defendant was served with the summons and complaint, as shown by the return of service affixed to the original summons in this case or by 3. Tha t the defendant has failed to appear or to answer the complaint or to notify the court of intent to contest the case within t he time provided in Rule 4 of the Rules of Civil Procedure for Magistrate Courts. 4. That the claim in the case is (check one) : a. For the amount of $ , as alleged due and owing in the complaint and is still due and owing: or b. For the amount of $ , which is the amount of $ as alleged in the complaint reduced by the amount of $ paid since the suit was instituted; or c. For an amount that can by computation be made certain. 5. That the defendant (check one) : a. Is not an incompetent person, infant or incarcerated convict; or b. Is an incompetent person, infant or incarcerated convict who is represented by a guardian, committee or guardian ad litem. W.Va. Code 24750-4-10; Mag. Civ. Rule 10. 50 U.S.C. APPENDIX 247520; FILE SCA-M429-2 / 10-96 PLAINTIFF222S COPY Docket Code(s): MCADJ American LegalNet, Inc. www.FormsWorkFlow.com 6. That the following represents the military status of the defendant (check one and complete as appropriate) : a. I have determined that the defendant is not in the military service based on the following facts: or b. I am not able to determine whether or not the defendant is in the military service. or c. The defendant is in military service. WHEREFORE, I request this Court to enter judgment against the defendant by awarding me the amount claimed plus interest and costs and, if applicable, $ for certified mail expenses. Plaintiff222s Signature Taken, subscribed, and sworn or affirmed before me this day of . My Commission expires on Notary Public/Magistrate Assistant/Magistrate Clerk W.Va. Code 24750-4-10; Mag. Civ. Rule 10. 50 U.S.C. APPENDIX 247520; FILE SCA-M429-2 / 10-96 PLAINTIFF222S COPY Docket Code(s): MCADJ American LegalNet, Inc. www.FormsWorkFlow.com