Fill and Sign the Defendants Name Amp Address If Two or More Defendants Form

MAGISTRATE COURT OF ____________________ COUNTY, GEORGIA DATE FILED ______________________ Dispossessory CASE NO. _____________________ ___________________________________________ ___________________________________________ ___________________________________________ Plaintiff’s Name & Address vs. ___________________________________________ _______________________________________________ ___________________________________________ _______________________________________________ ___________________________________________ _______________________________________________ Defendant’s Name & Address Defendant’s Name & Address (If two or more Defendants) ____________________________________________________________________________________________________________ AFFIDAVIT- - Personally appeared the undersigned affiant who on oath says that affiant is the [ ] owner, [ ] attorney at law, [ ] agent for Plaintiff(s) herein, and that Defendant(s) is/are in possession as tenant(s) of premises at the address stated above, in ________________ County, the property of said Plaintiff(s). Plaintiff(s) attest(s) that there are no other person(s)/entity(ies) or known occupant(s) with whom Plaintiff(s) has/have a landlord tenant relationship. [ [ [ [ FURTHER THAT: (check applicable claim(s)): ] tenant fails to pay the rent which is now past due; ] tenant holds the premises over and beyond the term for which they were rented or leased to tenant; ] tenant is a tenant at sufferance; ] Other: _________________________________________________________________________________; and THAT Plaintiff(s) is/are entitled to recover any and all rent that may come due until this action is finally concluded. Plaintiff(s) desires and has demanded possession of the premises and Defendant(s) has/have failed and refused to deliver said possession. WHEREFORE, Plaintiff(s) demand(s) (a) possession of the premises; (b) past due rent of $__________________________________; (c) rent accruing up to the date of judgment or vacancy at the rate of $ _________________ per day. (Calculate daily rental rate, if seeking rent accruing to date of judgment or vacancy.) (d)_________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ Sworn to and subscribed before me, this _______ day of ___________________, 20_____. ____________________________________________ Affiant [ ] Owner [ ] Attorney at Law [ ] Agent ___________________________________________ Attesting Official SUMMONS -- To the Sheriff of this County or lawful deputies of the Sheriff -- GREETINGS: The Defendant(s) is/are commanded and required to file an answer to said affidavit in writing or orally i n person at the Magistrate Court of _______________ County, Georgia on or before the seventh (7th) day after the date of servi ce of thi s affidavit and summons. If such answer is not made, a Writ of Possession and/or Judgment shall issue as provided by law. Witness the Honorable Chief Magistrate of said Court. 18 This _______day of _______________, 20 _____. ____________________________________________ Magistrate or Deputy Clerk The last possible date to file an answer: ______________________