Fill and Sign the Michigan Default Request Affidavit Entry and Judgment Sum Certain Form

Court telephone no. MC 07a (12/12) DEFAULT REQUEST, AFFIDAVIT, ENTRY, AND JUDGMENT (SUM CERTAIN) Approved, SCAO STATE OF MICHIGAN CASE NO. JUDICIAL DISTRICT JUDICIAL CIRCUIT v Court address Plaintiff name, address, and telephone no. Defendant name, address, and telephone no. Plaintiff's attorney, bar no., address, and telephone no. Defendant's attorney, bar no., address, and telephone no.Original - Court 1st copy - Plaintiff Copies - All other parties DEFAULT REQUEST, AFFIDAVIT, ENTRY, AND JUDGMENT (SUM CERTAIN) MCL 32.517, MCL 600.2441, MCL 600.5759, MCL 600.6013, MCR 2.603(B)(2), 50 USC 521 DateSignature REQUEST AND AFFIDAVIT 1. I request a default entry against for failure to appear. 2. The claim against the defaulted party is for a sum certain or for a sum, which by computation can be made certain. I request judgment for: Damages: $Costs: $ Attorney fee/Other: $ Total judgment:$ . 3. The amount requested for damages is not greater than the amount stated in the complaint. 4. The defaulted party is not an infant or incompetent person. 5. It is unknown whether the defaulted party is in the military service. The defaulted party is not in the military service. The defaulted party is in the military but there has been notice of pendency of the action and adequate time and opportunity to appear and defend has been provided. Attached, as appropriate, is a waiver of rights and protections provided under the Servicemembers Civil Relief Act. Facts upon which this conclusion is based are: (specify) 6. This affidavit is made on my personal knowledge and, if sworn as a witness, I can testify competently to the facts in this affidavit. Subscribed and sworn to before me on , County, Michigan. My commission expires:Signature: Notary public, State of Michigan, County of DEFAULT JUDGMENT IT IS ORDERED this judgment is granted in favor of the plaintiff(s) as follows. Damages: $ Costs: $ Attorney fee/Other: $ Total judgment: $ This judgment will earn interest at statutory rates, computed from the filing date of the complaint. Judgment interest accrued thus far is $ and is based on: If needed, attach separate sheet. the statutory rate of % from to . the statutory 6-month rate(s) of % from to . CERTIFICATE OF MAILINGI certify that on this date I served a copy of this default entry and judgment on the parties or their attorneys by first-class mail addressed to their last-known addresses as defined by MCR 2.107(C)(3). Date Deputy court clerk/Notary public Date Applicant/Attorney signature Bar no. DateCourt clerk/Judge DEFAULT ENTRY The default of the party named above for failure to appear is entered. DateCourt clerk *Attach bill of costs if statutory limit is exceeded. USE NOTE: Plaintiff must complete the Request and Affidavit and the Default Judgment before filing with the court. The judgment has been entered and will be final unless, within 21 days of the default judgment date, a motion to set aside the default is filed.