Verified Complaint For Illegal Lockout Or Utility Shutoff {29}

1 2 3 4 5 6 7 8 9 10 11 12 vs. 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Apartment Tenant Verified Complaint for Illegal Lockout or Utility Shutoff Form #29 IN THE JUSTICE COURT OF __________________________ TOWNSHIP IN AND FOR THE COUNTY OF _________________, STATE OF NEVADA Name: Address: Phone: ______________________ ______________________ ______________________ ______________________ Landlord/Plaintiff CASE NO: ________________ _____________________ _____________________ _____________________ _____________________ Tenant/Defendant DEPT. NO:________________ Name: Address: Phone: VERIFIED COMPLAINT FOR ILLEGAL LOCKOUT OR UTILITY SHUTOFF The Tenant named above hereby files this Complaint against the Landlord named above and hereby alleges as follows: 1. PLEASE CHECK ONE OF THE FOLLOWING: _____ A. The Landlord has not started a pending legal action for summary eviction or a pending legal action for unlawful detainer against me. (If you check A, you CAN use this form.) 1 of 6 ©2006 Nevada Supreme Court Revised: April 14, 2006 American LegalNet, Inc. www.FormsWorkflow.com 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 5. 16 6. 17 18 4. 3. 2. _____ B. The Landlord has started a pending legal action for summary eviction or a pending legal action for unlawful detainer against me, or I have already been locked out pursuant to another action. CANNOT use this form. Packet.) (If you check B, you See Tenant Instruction The parties entered into a rental agreement on or about the _____ day of _______________, 20____. The street address for my rental unit is: _______________________ ________________________________________________________ PLEASE CHECK ONE OF THE FOLLOWING: _____ A. _____ B. The rental agreement was not in writing. The rental agreement was in writing. A copy of the rental agreement is attached. The amount of rent was $____________. PLEASE CHECK ONE OF THE FOLLOWING: _____ A. _____ B. I pay rent weekly. I pay rent monthly. I pay rent as follows: ____________________________ ____________________________________________. 19 _____ C. 20 21 7. 22 _____ A. 23 _____ B. 24 rent. 25 8. 26 __________________, 20____. 27 28 Apartment Tenant Verified Complaint for Illegal Lockout or Utility Shutoff Form #29 PLEASE CHECK ONE OF THE FOLLOWING: My rent payments are current. My rent is not current. I am $_____________ behind in My next rental payment is due on the _____ day of 2 of 6 ©2006 Nevada Supreme Court Revised: April 14, 2006 American LegalNet, Inc. www.FormsWorkflow.com 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 9. PLEASE CHECK ONE OR BOTH OF THE FOLLOWING: _____ A. The Landlord barred me from entering/locked me out of my rental unit on or about the ______ day of ___________________________, 20____. _____ B. The Landlord stopped my utilities or other essential services on or about the _______ day of ___________________________, 20____. 10. Please describe how the landlord blocked entry, changed the locks and/or stopped the essential services._________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ _______________________________________________________. 11. PLEASE CHECK ONE OR BOTH OF THE FOLLOWING: _____ A. After I was blocked entry to/locked out of the rental unit, I tried to get back into the rental unit, but the Landlord refused to let me in. _____ B. After the Landlord stopped my utilities or other essential services, I asked the Landlord to restore the services, but the Landlord refused. 12. As a result of the Landlord's actions, I have damages as follows. In addition to the statutory damages of $1,000.00 allowed under NRS 118A.390, I am asking to be compensated for the following items of damages: Apartment Tenant Verified Complaint for Illegal Lockout or Utility Shutoff Form #29 3 of 6 ©2006 Nevada Supreme Court Revised: April 14, 2006 American LegalNet, Inc. www.FormsWorkflow.com 1 2 3 4 5 6 7 13. 8 9 AMOUNT $_______ $_______ $_______ $_______ $_______ $_______ DESCRIPTION ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Based upon the above, Tenant requests that this Court: _____ A. Find that the Landlord has violated NRS 118A.390 and/or NRS 118A.480; 10 _____ B. 11 not to exceed the jurisdictional limit of the Justice Court. 12 _____ C. 13 and/or restoring the utilities or essential services at the 14 rental unit; and 15 _____ D. 16 118A.390 and, if the circumstances so warrant, hold 17 Landlord in contempt of court. 18 Submitted by, 19 20 21 22 23 24 25 26 27 28 Apartment Tenant Verified Complaint for Illegal Lockout or Utility Shutoff Form #29 Assess actual and statutory damages against Landlord Issue an immediate order restoring me to the rental unit Enjoin the Landlord from violating the provisions of NRS ___________________________ Date _____________________________ Signature of Tenant/Plaintiff _____________________________ Print Name of Tenant/Plaintiff 4 of 6 ©2006 Nevada Supreme Court Revised: April 14, 2006 American LegalNet, Inc. www.FormsWorkflow.com 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Apartment Tenant Verified Complaint for Illegal Lockout or Utility Shutoff Form #29 VERIFICATION I, _________________________________, have read the foregoing Verified Complaint and know that the contents are true of my own knowledge except for those matters therein stated on information and belief, and as to those matters, I believe them to be true. ___________________________ Date _____________________________ Signature of Tenant/Plaintiff _____________________________ Print Name of Tenant/Plaintiff 5 of 6 ©2006 Nevada Supreme Court Revised: April 14, 2006 American LegalNet, Inc. www.FormsWorkflow.com 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 I swear the above is true. Signature:__________________________________ SUBSCRIBED AND SWORN to before me this ____ day of _________________, 20____. NOTARY PUBLIC OR DEPUTY CLERK _____________________________ OR THE FOLLOWING: Pursuant to NRS 53.045: "I declare under penalty of perjury under the law of the State of Nevada