Fill and Sign the Trial Court of Masschussetts Form

Trial Court of Masschussetts District Court Department DIVISION DOCKET NO. REQUEST FOR DEFAULT JUDGMENT (Mass R. Civ P. 55(b)(3)) I, ________________________________________________________________, the\ undersigned, request that default judgment be entered against the defendant(s) _______________________\ _____________ in the amount of $_______________ 1. 2. The defendant is not an infant or incompetent person. 3. ______________________________________________________________________\ ___________________________ ______________________________________________________________________\ ___________________________ _____________________________________________________________________\ ____________________________ Signature: ___________________________________________ Name: ______________________________________________ Attorney for: __________________________________________ Address: _____________________________________________ Telephone: ___________________________________________ The defendant is not in the military service of the United States or its\ Allies, as defined in the Servicemembers Civil Relief Act as evidenced by the following facts: together with interest in the sum of $_________________ with costs and\ affirm that: The total amount due the plaintiff(s), exclusive of costs in his claim\ against the defendant, is $__________________. REQUEST FOR DEFAULT JUDGMENT DEFENDANT'S NAME, ADDRESS, ZIP CODE AND PHONE ________________________________________________ ________________________________________________ ________________________________________________ PLAINTIFF'S NAME, ADDRESS, ZIP CODE AND PHONE ________________________________________________ ________________________________________________ ________________________________________________ ___________________________