Eviction Application Form

EVICTION APPLICATION FORM

Applicant Name:    Applicant Capacity:    ("Applicant") and Respondent Name: ("Respondent") submit this Eviction Application to seek relief regarding the premises described below.

RECITALS

WHEREAS, Applicant is the lawful owner or authorized agent of the real property located at (the "Premises"); and

WHEREAS, Respondent occupies or has occupied the Premises pursuant to a tenancy, lease, license, or permissive occupancy and has failed to comply with obligations under the tenancy as set forth in this application; and

WHEREAS, Applicant alleges that Respondent's conduct or failure to perform entitles Applicant to recover possession, damages, and other relief as permitted by statute and/or lease.

NOW THEREFORE, Applicant respectfully applies to the appropriate tribunal for an order granting possession of the Premises and such other relief as set forth below, and alleges the following facts under penalty of perjury.

1. PARTIES AND JURISDICTION

1.1 Applicant is and is authorized to bring this application as owner or agent.

1.2 Respondent's last known address at the Premises is the address set forth above. This tribunal has jurisdiction over the subject matter and the parties pursuant to applicable law governing residential and/or commercial landlord-tenant disputes.

2. PROPERTY AND TENANCY

2.1 Lease or tenancy commencement date: . Lease or agreement type: .

2.2 Lease termination or alleged breach date (if applicable): . Security deposit held by Applicant: .

3. GROUNDS FOR EVICTION

Applicant alleges the following grounds (check all that apply):

Nonpayment of rent Breach of lease or rental agreement Holdover after termination or expiration of tenancy Nuisance or substantial interference with others' use of premises Illegal activity on the Premises Other (describe below)

4. STATEMENT OF FACTS

Provide a concise chronology of relevant events, breaches, notices, and Respondent's conduct. Include amounts owed and dates served below. If additional pages are attached, identify them in the Attachments section.

5. NOTICE AND SERVICE

5.1 Notice(s) given to Respondent (check applicable and state date served):

Pay or quit notice served on: Cure or quit notice served on: Termination notice served on:

5.2 Method of service (select all that apply):

Personal delivery to Respondent Substituted service at the Premises Mailing to last known address Posting on the Premises

6. DAMAGES, RENT, AND RELIEF REQUESTED

6.1 Amount of unpaid rent claimed: $ as of .

6.2 Other damages and charges (late fees, utilities, repairs): $ . Describe:

6.3 Applicant requests the following relief: (check all that apply)

Judgment for possession of the Premises Money judgment for unpaid rent and charges Costs, filing fees, and reasonable attorney fees (if applicable) Other relief as the tribunal deems just and proper

7. ATTACHMENTS

Include copies of documents supporting this application. Check all attachments provided:

Copy of lease or rental agreement Copies of notices served Payment history or ledger Photographs or other evidence Other documents (describe below)

8. DECLARATION AND CERTIFICATION

I declare under penalty of perjury under the laws of the applicable jurisdiction that the foregoing is true and correct to the best of my knowledge, that I am authorized to bring this application on behalf of Applicant, and that all notices required by law or by the lease have been given as indicated above.

9. GOVERNING LAW

This application and any proceedings arising from it shall be governed by the laws of the jurisdiction in which the Premises are located and any applicable local landlord–tenant statutes and procedural rules.

10. ENTIRE AGREEMENT; SEVERABILITY

This application, together with any attachments, constitutes the entire written statement of Applicant's claims in this matter. If any provision of this application is held invalid, illegal, or unenforceable by a tribunal of competent jurisdiction, the remaining provisions shall remain in full force and effect.

11. NOTICES

All notices required by this application shall be in writing and shall be deemed sufficiently given when personally delivered or when mailed to the addresses set forth in this application or as later provided in writing.

12. AMENDMENTS; WAIVER; COUNTERPARTS

This application may be amended by Applicant upon written notice filed with the tribunal. No waiver of any breach shall be effective unless in writing and signed by the waiving party. This application may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one instrument.

13. CONTACT FOR SERVICE

14. SIGNATURES

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