Fill and Sign the In Summary Ejectment Form

Name And Address Of Defendant 2 Individual Corporation Name And Ad dress Of Defendant 1 Individual Corporation File No. CERTIFI CATION WHEN COMPLAINT SIGNED BY AGENT OF PLAINTIFF Amount Of Rent Past Due (Over) The def endant is a resident of the county named above. Conventional Pub lic Housing Section 8 The def endant failed to pay the rent due on the above date and the plainti ff made demand for the rent and waited the 10-day grace period be fore filing the complaint. The def endant owes the plainti ff the follow ing: The plainti ff has dem anded possession of the premises from the def endant, wh o has refused to surr ender it, and the plainti ff is entitled to immediate possession. I demand to be put in possession of the premises and to recover the total amount listed above and daily rental until entry of judgment plus interest and reimbursement for court costs. Type Of Lease STATE OF NORTH CAROLINA In The General Court Of Justice District Court Division-Small Claims County COMPLAINT IN SUMMARY EJECTMENT G.S. 7A-216, 7A-232; Ch. 42, Art. 3 and 7 1. VERSUS Telephone No. AOC-CV M-201, Rev. 9/13 © 2013 Administrative Office of the Courts 4. Signature Of Agent The def endant entered into possession of premises described below as a lessee of plaintiff. Description Of Any Property Damage 6. Signature Of Plaintiff/Attorney/Agent I certify that I am an agent of the plaintiff and have actual knowl edge of the facts alleged in this Complaint. $ $ $ The def endant breached the condition of the lease described below for which re-entry is specified. 3. per Date Lease Ended Oral The lease period ended on the above date and the def endant is holding over after the end of the lease period. Criminal activity or other activity has occurred in violation of G.S. 42-63 as specified below. $ Month Week Written 5. 2. Name And Ad dress Of Plaintiff Name And Ad dress Of Plaintiff's Attorney Or Agent County Telephone No. County County Description Of Premises (Include Location) Description Of Breach/Criminal Activity (give names, dates, places and illegal activity) Date Rent Due Telephone No. Date DateAmount Of Damage (If Known) Total Amount Due Rate Of Rent Name Of Plaintiff/Attorney/Agent (Type Or Print) Name Of Agent (Type Or Print) The PLAINTIFF must file a small claim action in the county where at least one of the defendants resides. The PLAINTIFF cannot sue in small claims court for more than $10,000.00 excluding interest and costs unless further restricted by court order. The PLAINTIFF must show the complete name and address of the def endant to ensure service on the defendant. If there are two defendant s and t hey reside at differen t addresses, the plaintiff must include both addresses. The plaintiff must determine if the defendant is a corporation and sue in the complete corporate name. If the business is not a corporation, the plaintiffmust determine the owner's name and sue the owner. The PLAINTIFF may serve the defendant(s) by mailing a copy of the s ummons and complaint by registered or certified mail, return receipt requested, addressed to the party to be served or by paying the costs to have the sheriff serve the summons and complaint. If certified or registered mail is used, the plaintiff must prepare and file a sworn statement with the Clerk of Superior Court proving service by certified mail and must attach to that statement the postal receipt showing that the letter was a ccepted. In filling out number 3 in the complaint, if the landlord is seeking to remove the tenant for failure to pay rent when there is no written lease, the first block should be checked. (Defendant failed to pay the rent due on the above date and the plaintiff made demand for the rent and waited th e ten (10) day grace period before filing the complaint.) If the landlord is seeking to remove the tenant for failure to pay rent when there is a written lease with an automatic forfeiture clause, the third block should be checked. (The defendant breached the condition of the lease described below for which re-entry i s specified.) And “failure to pay rent” should be placed in the space for description of the breach. If the landlord is seeking to evict tenant for violating some other condition in the lease, the third block should also be checked. If the landlord is claiming that the term of the lease has ended and the tenan t refuse s to to leave, the second block should be checked. If the landlord is claiming that cri minal activity occurred, the fourth block should be checked and the conduct must be described in space provided. AOC-CVM-201, Side Two, Rev. 9/13 © 2013 Administrative Office of the Courts INSTRUCTIONS TO PLAINTIFF OR DEFENDANT 1. 2. 3. 4. 5. The PLAINTIFF must pay advance court costs at the time o f filing this Complaint. In the event that judgment is rendered in favor of the plaintiff, court costs may be charged against the defendant. The PLAINTIFF must appear before the magistrate to prove his/her claim. The DEFENDANT may file a written answer, making defense to the claim , in the o ffice of the Clerk of Superior Court. This answer should be acc ompanied by a copy for the plaint i ff and be filed no later than the time set for trial. The filing of the answer DO ES NOT relieve the defendant of the need to appear appear before the magistrate to a ssert the defendant’s defense. The PLAINTIFF or the DEFENDANT may appeal the magistrate's decision in this case. To appeal, notice must be given in open court when the judgment is entered, or notice may be given in writing to the Clerk of Superior Court within ten (10) days after the judgment is entered. If notice is given in in writing, the appealing party must also serve written notice of appeal on all other parties. The appealing party mus t PAY to the Clerk of S uperior Court the costs of court for appeal within ten (10) days after the judgment is entered. If the appealing party applies to appeal as an indigent, and that reques\ t is denied, that party has an additional five (5) days to pay the court co\ sts for the appeal. If the defendant appeals and wishes to remain on the premises the defendant must also post a sta y of execution bond within ten (10) days after the judgment is entered. In the event of an appeal by the tenant to district court, the landlord may file a motion to dismiss that appeal un\ der G.S. 7A-228(d). The court may decide the motion without a hearing if t\ he tenant fails to file a response within ten (10) days of receipt of the\ motion. This form is supplied in order to expedite the handling of small claims. It is designed to cover the most common claims. 6. 7. 8. 11. 12. 14. The Cl erk or magistrate cannot advise you about your case or assist you in completing this form. I f you have any questions, you s hould consult an attorne y. 15. Requests for continuances of cases before the magistrate may be granted for go od cause shown and for no more than five (5) da ys per continuance unless the parties agree otherwise. 9. The magistrate will render judgment on the date of hearing unless the pa\ rties agree otherwise, or the case is complex as defined in G.S. 7A-222, in wh\ ich case the decision is required within five (5) days. 10.. Upon request o f the tenan t within seven (7) days o f the landlord being pla ced in lawful possession , the landlord shall release any personal property o f the tenan t. After seven (7) days, the landlord may sell, throw awa y or dispose o f said proper ty. If sold , the landlord mus t disburse any surplus proceeds to the tenant upon request within seven (7) days o f the sale . If the total value o f the pr operty i s less than $500.00 , it is deemed abandoned five (5) days after execution. 13.