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JUSTICE COURT, HENDERSON TOWNSHIP (Civil Law Self-Help Center)

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1
JUSTICE COURT, HENDERSON TOWNSHIP
CLARK COUNTY, NEVADA
Tenant,
vs.
Landlord,
CASE NO.
To be completed by court staff
DEPT NO.
To be completed by court staff
VERIFIED COMPLAINT FOR
EXPEDITED RELIEF FOR THE
REMOVAL OR EXCLUSION OF
THE TENANT OR THE WILLFUL
INTERRUPTION OF ESSENTIAL
SERVICE
The Tenant named above hereby files this Complaint against the Landlord named above and
hereby alleges as follows:
1. PLEASE CHECK ONE OF THE FOLLOWING BOXES:
The Landlord has not
instituted a pending legal action for summary eviction or a pending legal
action for unlawful detainer against me.
IF THIS BOX IS CHECKED, YOU CAN USE THIS FORM.
The Landlord has instituted a pending legal action for summary eviction or a pending legal
action for unlawful detainer against me, or I have already been locked out pursuant to a prior
action.
IF THIS BOX IS CHECKED, YOU CANNOT USE THIS FORM.
INSTEAD, YOU MUST FILE A “MOTION TO PLACE ON CALENDAR” USING
THE CASE NUMBER FOR THE CASE WHICH THE LANDLORD HAS FILED.
2. The parties entered into a rental agreement on or about the day of , 20 .
3. The Nevada address for the property at issue is as follows:
STREET ADDRESS:
CITY:
ZIP CODE:
Name:
Address:
City, State, Zip:
Phone:
Email:
Name:
Address:
City, State, Zip:
Phone:
Email:
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2
4. PLEASE CHECK ONE OF THE FOLLOWING BOXES:
The rental agreement was not in writing.
The rental agreement was in writing.
(PLEASE ATTACH A COPY OF THE RENTAL AGREEMENT IF ONE IS AVAILABLE.)
5. The amount of rent is $ .
6. PLEASE CHECK ONE OF THE FOLLOWING BOXES:
I pay rent weekly.
I pay rent monthly.
I pay rent as follows:
7. PLEASE CHECK ONE OF THE FOLLOWING BOXES:
My rent payments are current.
My rent is not current. I am $ in arrears.
8. My next rental payment is due on the day of , 20 .
9. PLEASE CHECK ONE OR BOTH OF THE FOLLOWING BOXES:
The Landlord barred me from entering my dwelling unit on or about the day of
, 20 .
The Landlord terminated my utilities or other essential services on or about the day of
, 20 .
NOTE
: If the power/gas/water company terminated your utilities for unpaid bills, you will not be
entitled to relief from the Court.
NOTE:
This Complaint is required to be filed within 5 judicial days after the date of the unlawful
act by the landlord. If this time period has been exceeded, this Complaint for Expedited Relief
will be dismissed, but you will retain the right to pursue all other available remedies against the
Landlord.
3
10. PLEASE DESCRIBE THE FACTUAL CIRCUMSTANCES SURROUNDING THE BLOCKED
ENTRY AND/OR THE TERMINATION OF ESSENTIAL SERVICES:
(For example, if you were barred from entry, please describe how this was done.
If your utilities were terminated, please state which utilities were affected.)
NOTE: Please make sure that the information you provide is LEGIBLE
.
11. PLEASE CHECK ONE OR BOTH OF THE FOLLOWING BOXES:
After I was blocked entry to the premises, I tried to get back into the dwelling, but the
Landlord refused to let me in.
(If available, please attach a copy of any letters sent to, or from
, the Defendant Landlord.)
After the Defendant Landlord terminated my utilities or other essential services, I tried to
convince Defendant Landlord to restore the services, but the Landlord refused.
(If available, please attach a copy of any letters sent to, or from, the Defendant Landlord.)
12. As a result of the Defendant Landlord’s actions, I have incurred damages as follows:
In addition to statutory dam
ages of $1,000.00 allowed under NRS 118A.390, I am seeking to be
comp
ensated for the following items of damages:
AMOUNT: DESCRIPTION:
$
$
$
$2,500.00
4
13. Based on the above, Plaintiff requests that this Court:
(a) Find that the Defendant Landlord has violated NRS 118A.390 and/or NRS 118A.480;
(b) Assess actual and statutory damages against Defendant Landlord not to exceed the
jurisdictional limit ($7,500.00) of Justice Court;
(c)
Issue an immediate order restoring me to the premises and/or restoring the utilities or
essential services at the premises; and
(d) Enjoin the Landlord from violating the provisions of NRS 118A.390 and, if the
circumstances so warrant, hold Landlord in contempt.
14. VERIFICATION: I have read the foregoing Verified Com
plaint and know the contents thereof, and
the contents are true of my
own knowledge except for those matters therein stated on information and
belief, and as to those matters, I believe them to be true.
DATED: BY:
(Tenant’s Signature)
15. DECLARATION: I declare under penalty of perjury under the law of the State of Nevada that the
foregoing is true and correct.
Executed on
BY:
(Date) (Tenant’s Signature)
NOTE: Unless this Complaint is dism
issed for the reasons stated above, the Court will conduct a
hearing on this Verified Complaint for Expedited Relief within 3 judicial days after the date
this document is filed.
Either before or at the scheduled hearing, you must provide proof that the Landlord has
been properly served wi
th this document, or you will be entitled to no relief
5
THIS ENTIRE PAGE IS TO BE COMPLETED BY COURT STAFF:
NOTICE OF MOTION
TO: _______________________________________ (Landlord)
You will please take notice that a hearing will be held on this “Verified Complaint for Expedited
Relief for the Unlawful Removal or Exclusion of the Tenant or the Willful Interruption of Essential Services.”
This hearing will be held in the Henderson Justice Court in Department No. ______________, located at
243 Water Street, Henderson, Nevada, on the ___________ day of ________________________,
20______, at the hour of ____________ _____M.
Although you are not required to file a written response to the Motion, failure to appear at the he
aring
may result in the requested relief being granted by the Court in your absence.
The purpose of this hearing is to address the Tenant’s right to be im
mediately restored to the premises
and/or the Tenant’s right to have utilities or other essential services restored. Moreover, Tenant may also be
entitled to an award of damages against you, so you may wish to consult with an attorney prior to the
scheduled hearing.
DATED: _____________________ __________________________________________
Court Clerk,
Henderson Justice Court
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JUSTICE COURT, HENDERSON TOWNSHIP (Civil Law Self-Help Center)

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Completed 8 January 2021

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