Fill and Sign the Free State of Minnesota County Select County District Form

State of Minnesota District Court County Judicial District: Court File Number: Case Type: Housing Plaintiff (Tenant) Release Of Rent vs. (Minn. Stat. § 504B.385, subd. 7) Defendant (Landlord) † By Plaintiff Before Hearing The undersigned plaintiff(s) declares to the Court that the violations cited by the inspecting authority and/or by the plaintiff in the Affi davit of Rent Escrow have been remedied and the corrections are satisfactory. It is further understood and agreed that the escrowed rent in the amount of $ , on deposit with the Court, may be im mediately released to the Defendant (landlord) and the scheduled hearing may be cancelled. (Only Plaintiff must sign below.) † By Stipulation Before Hearing Plaintiff and Defendant agree that the escrowed rent in the amount of $ , on deposit with the Court, may be immediately released by the Court as follows: To Plaintiff $ To Defendant $ . The scheduled hearing may be cancelle d. (Both parties must sign below.) Plaintiff (Tenant) Defe ndant (Landlord/Agent/Attorney) Date: Date: Signature Signature (Required only if stipulation) Name: Name: Street Address: Street Address: City/State/Zip: City/State/Zip: Telephone: ( ) Telephone: ( ) Sworn/affirmed before me this Sworn/affirmed before me this __________ day of ________________,______ __________ day of ________________,______ Notary Public/Deputy Court Administrator Notary Public/Deputy Court Administrator Any Signature Must Be Before A Notary Public Or Deputy Court Administrator HOU303 State ENG Rev 9/01 www.courts.state.mn.us/forms Page 1 of 1