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KEN BURKE, C.P.A. CLERK OF THE CIRCUIT COURT (Pinellas County Clerk of the Circuit Court and Comptroller)

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KEN BURKE, C.P.A.
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
PINELLAS COUNTY, FLORIDA
www.mypinellasclerk.org
PACKAGE FEE: $6.45
RESIDENTIAL TENANT EVICTION
NON-PAYMENT OF RENT
(POSSESSION & DAMAGES)
Please contact the Clerk’s Office at (727) 464-7000 or visit us online at
www.mypinellasclerk.org for additional information.
04/2021
COMPLAINT FOR EVICTION
-OR-
COMPLAINT FOR EVICTION AND DAMAGES
*** Important Information ***
Notice: Information or forms provided by the Clerk of the Circuit Court should be
considered as basic information only and may not be applicable to every
situation. The information is not intended to be used as legal advice. Specific
guidance concerning filing a lawsuit, answering a lawsuit or questions about your
particular situation should be directed to a qualified attorney.
A tenant eviction is the legal procedure a landlord must follow to have a tenant
removed from the landlord’s property.
FILING FEES:
Tenant Eviction (Possession Only) $185.00
Tenant Eviction and Damages under $2,500.00 $185.00
Tenant Eviction and Damages of $2,501.00 – $15,000.00 $300.00
Tenant Eviction and Damages over $15,001.00 $400.00
Summons Issuance Fee $10.00 Per Summons
IN ADDITION TO THE FILING FEE AND SUMMONS ISSUANCE FEE, you must
contact a private process server, or persons allowed to do service in the county
where the service to be done, to obtain their service fees. You can get a list of
local process servers from the Sheriff by accessing a link through the Clerk’s
website at www.mypinellasclerk.org (look for Process Servers under Find a Service)
• If service is outside of Pinellas County, you must contact the Sheriff of that
county to obtain applicable service fees.
When should this packet be used?
• Residential Tenant Eviction and Damages is used to obtain possession of the
property for non-payment of rent and back payment of rent (damages).
• The tenant did not pay the rent based on an oral or written lease agreement
on a residential property.
Example – You are the owner and/or landlord and you have a rental
agreement with a tenant. The tenant is not paying the rent. You want them
evicted, and you want to recover the back payment of rent.
Before a lawsuit is filed, you must deliver the Notice from Landlord to Tenant –
Termination for Failure to Pay Rent [Form #1]
Review the Filing Checklist and Quick Reference Guide prior to completing any
forms.
Refer to chapters 45 through 57 and chapter 83 of the Florida Statutes for
information regarding filing a tenant eviction case.
• Copies of these statutes are available at the law library located at the Clearwater Courthouse, at
your public library or online through the Florida Legislature website at
http://www.leg.state.fl.us/Statutes
Do Not Sign any documents that require a notary or deputy clerk signature until
you are in front of the notary or deputy clerk.
Retain Copies of all forms filed for your records.
Documents Must Be Legible, type written or legibly handwritten in black or blue
ink.
It Is Important that the names and addresses are the same on all documents.
A Delay Can Occur as a result of any errors on your paperwork or if the proper
fees are not submitted.
Do Not Accept Any Rent after initiating the eviction process or your case may be
dismissed per Florida Statute 83.56(5).
SELF HELP CENTER
The Self Help Centers are the result of a collaborative effort between the Clerk’s Office, the Sixth Judicial Circuit,
the Community Law Program and the Clearwater Bar Association.
The purpose of the Clerk's Legal Self Help Centersis to assist citizensrepresenting
themselves in court (sometimes referred to as pro se persons) who do NOT have a private attorney.
Citizens who represent themselves in court and do not already have a private attorney representing them, can
now get affordable legal assistance.
OUR SERVICES IN
CLUDE:
• Schedule an appointment to consult with an attorney for a minimum of $15.00*
(Attorneys may assist with Family Law, Small Claims and Landlord/Tenant matters ONLY.)
• Purchase forms and packets for the civil court actions listed above
• Have documents notarized
• Make copies
Open Monday through Friday from 8:30 a.m. until 4:30 p.m.:
•
The Clearwater Self Help Center
The New Courthouse
315 Court Street
Clearwater, FL 33756
Phone: (727) 464-5150
Fax: (727) 453-3423
o Appointments may be scheduled for Wednesday,
Thursday and/or Friday.
o A Spanish interpreter provided by the
Hispanic Outreach Center is available by
appointment at the Clearwater location
•
The St. Petersburg Self Help
Center
The St. Petersburg Judicial Building
545 First Avenue North, Room 103
St Petersburg, FL 33701
Phone: (727) 582-7941
Fax: (727) 582-7945
o Appointments may be scheduled for
Monday, Wednesday, and/or Friday.
• The North County Branch Self Help Center
29582 U.S. 19 North
Clearwater, FL 33761
Phone: (727) 464-5150
Fax: (727) 453-3423
o Attorney appointments may be scheduled
for Tuesday only at this office.
Self Help Center Now Offering Online Scheduling of attorney consultation appointments for pro se litigants
that do not already have
an attorney. To schedule an appointment online using a credit card, please visit
www.mypinellasclerk.org
and click on the SELF HELP CENTER link in the top menu.
*Attorney appointments may only be scheduled for a minimum of 15 minutes to a maximum of one hour. All appointments must be
scheduled in 15-minute increments, i.e., 15, 30, 45 or 60 minutes at a rate of $1 (one dollar) per minute, therefore payments will be $15, $30,
$45 or $60 accordingly.
Attorney consultation fees must be paid when the appointment time is scheduled. Payments must be by cash, check, money order or credit card.
Refunds will not be issued for missed appointments.
Ken Burke, CPA
Clerk of the Circuit Court
& Comptroller
Pinellas County, Florida
DELINQUENT TENANT FLOWCHART – COUNT 1 POSSESSION ONLY
Landlord posts or delivers
Notice to Tenant
Wait 3 days (excluding Saturday, Sunday
and legal holidays observed by the clerk)
for failure to pay rent
Landlord files Complaint with attached Copy of Lease (if any) and Copy of
Notice, Civil Cover Sheet and Summons with Clerk – Clerk issues summons (1
original, 2 copies per defendant and self-addressed stamped envelopes)
Defendant Served
Wait 5 days from date of service or if posted, from
date of posting or mailing whichever is later
Answer from Tenant – No
rent monies deposited
No Answer from Tenant
and no monies deposited
Answer from Tenant and rent monies deposited,
No Answer but rent monies deposited or Answer
from Tenant and Motion to Determine Rent
Landlord files Motion for
Court Default, Non-
Military affidavit, Motion
for Final Judgment and
Final Judgment (1
original, 1 copy each
Plaintiff and Defendant
and self-addressed
stamped envelopes)
Landlord files Motion for
Clerk Default, Non-
Military affidavit, Motion
for Final Judgment and
Final Judgment (1
original, 1 copy each
Plaintiff and Defendant
and self-addressed
stamped envelopes)
Landlord files Non-Military affidavit
and Motion/Order to Set Cause for
Non-Jury Trial (1 original, 1 copy each
Plaintiff and Defendant and self-
addressed stamped envelopes)
Hearing Held
Landlord wins and prepares
Final Judgment for Judge
Landlord loses
suit
Court enters Final Judgment
If Tenant still in property Landlord files Writ of
Possession with the clerk and pays $90.00 to the sheriff
DELINQUENT TENANT FLOWCHART – COUNT 2 DAMAGES/MONEY
Money owed to Landlord
Tenant originally served
by personal service
Tenant originally served
by posting
Landlord files 20 day
Summons with Clerk
Defendant Served – Must
be Personal Service
Answer from Tenant
No Answer from Tenant
Landlord files Affidavit of Damages and
Motion/Order to Set Non-Jury Trial (1
original, 1 copy each Plaintiff and
Defendant and self-addressed stamped
envelopes)
Landlord brings Final Judgment to the
Hearing (1 original, 1 copy each Plaintiff
and Defendant and self-addressed
stamped envelopes)
Landlord files Affidavit of Damages, Motion
for Clerk Default, Motion for Default Final
Judgment and Final Judgment (1 original, 1
copy each Plaintiff and Defendant and self-
addressed stamped envelopes)
FILING CHECKLIST
RESIDENTIAL EVICTION FOR NON-PAYMENT OF RENT
(POSSESSION ONLY)
STEP ONE – FILE CASE WITH CLERK
To file an Eviction case, you may file the following forms along with the filing fee and any
service fees, if applicable, with the Clerk’s office.
_____ Complaint for Eviction with attached copy of the written lease agreement, if any, and
Notice to Pay Rent
_____ Civil Cover Sheet
_____ Authorization of Property Manager – Only provide if you are a property manager filing a
complaint on behalf of a landlord
_____ Summons on Claim for Possession of Residential Premises and/or Ancillary Relief – Must
include Spanish and French translations
(1) Original and (1) copy for each Defendant to be served*
*If you anticipate posting, per Florida Statute 48.183, the landlord must provide an additional copy of
the complaint, summons and a pre-addressed stamped envelope for mailing to each Defendant
STEP TWO – OBTAIN JUDGMENT – COUNT I
5 days (excluding weekends and legal holidays) after service on the Defendant(s) and the
defendant(s):
DID NOT respond OR deposit money into the registry of the court, you may file the following
forms:
_____ Nonmilitary Affidavit – Must be submitted per Local Rule 5(D) in order to obtain a Clerk’s
Default
_____ Motion for Clerk’s Default – Residential Eviction
_____ Motion for Default Final Judgment – Residential Eviction
_____ Final Judgment – Residential Eviction – (1) Original and (1) copy for each Plaintiff and
Defendant along with pre-addressed stamped envelopes for each party
OR
DID respond, but DID NOT deposit any money into the registry of the court, you may file the
following forms:
_____ Motion for Court’s Default – Residential Eviction
_____ Motion for Default Final Judgment – Residential Eviction
_____ Final Judgment – Residential Eviction – (1) Original and (1) copy for each Plaintiff and
Defendant along with a pre-addressed stamped envelopes for each party
OR
DID respond AND deposited money into the registry of the court OR DID respond AND filed a
Motion to Determine Amount of Rent, you may file the following forms:
_____ Motion/Order to Set Cause for Non-Jury Trial – Final Judgment – (1) original and (1) copy
for each Plaintiff and Defendant along with pre-addressed stamped envelopes for each
party
_____ Final Judgment – Residential Eviction – Bring the Final Judgment and (1) copy for each
Plaintiff and Defendant to the hearing along with pre-addressed stamped envelopes for
each party
Note – In some cases the Judge assigned to your case may require that you submit a
Nonmilitary Affidavit prior to signing the Final Judgment.
If the Judge grants your complaint, a Final Judgment will be signed.
STEP THREE – OBTAIN WRIT OF POSSESSION
If the Defendant(s) refuse to leave the property after the Final Judgment has been signed,
you may file a Writ of Possession and have it issued by the Clerk, allowing the Sheriff’s
Department to remove them from the property.
_____ Writ of Possession
Payment Options for Writ of Possession:
• $90.00 Check or money order payable to the Pinellas County Sheriff’s Office
o Submitted to the Clerk along with the Writ of Possession
• $90.00 Credit or Debit payment – PLC #8384 ($3.00 service fee applies)
o online at www.GovPayNow.com
o by phone at 1-888-604-7888
STEP FOUR – OBTAIN JUDGMENT – DAMAGES – COUNT II
In accordance with Florida Statute 48.031, in order to obtain a judgment for damages (count
II), a separate personal service must be made if the original summons was posted. If personal
service is needed, you may submit the following to the clerk at ANY time after the original
summons was posted.
_____ 20 Day Summons – Must include Spanish and French translations
(1) Original and (1) copy for each Defendant to be served
20 days after personal service on the Defendant(s) and the Defendants:
DID NOT respond OR deposit money into the registry of the court, you may file the following
forms:
_____ Affidavit of Damages
_____ Motion for Clerk’s Default – Damages
_____ Motion for Default Final Judgment – Damages
_____ Final Judgment – Damages – (1) Original and (1) copy for each Plaintiff and Defendant
along with a pre-addressed stamped envelopes for each party
OR
DID respond to Count II – Damages AND/OR deposit money into the registry of the court, you
may file the following forms:
_____ Affidavit of Damages
_____ Motion/Order to Set Cause for Non-Jury Trial – Final Judgment – (1) original and (1) copy
for each Plaintiff and Defendant along with pre-addressed stamped envelopes for each
party
_____ Final Judgment – Damages – (1) original and (1) copy for each Plaintiff and Defendant
along with pre-addressed stamped envelopes for each party
Additional Forms, if applicable
_____ Motion and Order to Disburse Funds from Registry of the Court
This form should only be used if any funds were deposited into the Registry of the Court
and you would like to have it disbursed to you.
_____ Disclosure form Nonlawyer
This form should only be used if a nonlawyer assists you in completing any forms. The
nonlawyer must complete the Disclosure form and both of you are to sign it prior to the
nonlawyer assisting you with any forms.
_____ Notice of Voluntary Dismissals
If you decide not to proceed with your case prior to a judgment being entered, you
should file a Notice of Voluntary Dismissal
_____ Notice from Landlord of Intent to Impose Claim on Security Deposit
Pursuant to F.S. 83.49(3)(a), you must return a tenant’s security deposit to the tenant no
more than 15 days after the tenant leaves the leased property. You may claim all or a
portion of the security deposit only after giving the tenant written notice by certified
mail to the tenant’s last known mailing address of your intention to keep the deposit and
the reason for keeping it. If the tenant does not object to the notice, you may keep the
amount stated in the notice and must send the rest of the deposit to the tenant within
30 days after the date of the notice.
After Damages Judgment
After the Court enters this Judgment you should obtain a certified copy of the judgment from
the Clerk of the Court and record the certified copy in the public records in any county in which
the tenant owns property. The Clerk of the Small Claims Court can probably provide you with
information concerning the collection of the amounts owed you.
A judgment for money (if properly recorded) is a lien upon the real or personal property of the
person against whom the judgment was entered for a period of ten years. The lien may then be
extended for an additional period of ten years by re-recording a certified copy of the judgment
prior to the expiration of the lien, and by simultaneously recording an affidavit with the current
address of the person who has a lien as a result of the judgment. The lien may not be extended
beyond twenty years from the date of entry of the judgment, or beyond the point the lien is
satisfied, whichever occurs first.
SOURCE: Sections 55.081 and 55.10, Florida Statutes
THIS DOES NOT CONSTITUTE LEGAL ADVICE. Civil court information
and forms provided by the Pinellas County Clerk of the Circuit Court
should be considered informational only, and may not be applicable
in every situation. The information is not intended to be used as legal
advice. Specific guidance as to how to proceed with filing or
answering a lawsuit and questions about your particular situation
should be directed to a qualified attorney.
Revised by the Clerk 04-2021
Quick Reference Guide to Completing
Tenant Eviction Forms Prior to Filing
Complaint for Residential Eviction:
• Fill in party names in the space provided (the plaintiff is the party initiating this action and
the defendant is the party against whom the case is initiated)
• Read each line and fill in the appropriate responses
• Date and sign in the space provided and print or type your name, address and telephone
number
• Attach the written agreement to pay rent, if any
• Attach the Notice from Landlord to Tenant – Termination for Failure to Pay Rent
All other forms:
• Fill in the names of the Plaintiff(s) and Defendant(s)
• Read each line and select and/or fill in the appropriate responses.
• Date and sign in the space provided and print or type your name, address and telephone
number
o If required, date and sign in the presence of a Notary Public or Deputy Clerk.
Form 1 Revised by Clerk 04/2021
NOTICE FROM LANDLORD TO TENANT – TERMINATION FOR FAILURE TO PAY RENT
To:
From:
You are hereby notified that you are indebted to me in the sum of $___________________ for the rent
(insert amount owed by tenant)
and use of the premises located at ________________________________________________________,
(insert address of premises including county)
Florida, now occupied by you and that I demand payment of the rent or possession of the premises
within three days (excluding Saturday, Sunday and Legal Holidays) from the date of delivery of this
notice to-wit: on or before the ______ day of ___________________, 20_____.
(three days from delivery of notice – excludes date of delivery, Saturday, Sunday and legal holidays)
_______________________________________
Signature
_______________________________________
Name of Landlord/Property Manager (circle one)
_______________________________________
Address (street address were Tenant can deliver rent)
_______________________________________
City, State, Zip Code
_______________________________________
Telephone Number
Hand Delivered on:_________________
Posted on:________________________
Approved for use under rule 10-2.1(a) of the Rules
Regulating The Florida Bar
The Florida Bar 2010 This form was completed with the assistance of:
Name: _________________________________
Address: _______________________________
City, State, Zip: __________________________
Telephone number: ______________________
Tenant’s Name:
Address:
City, State, Zip:
Date Delivered:
Form 5a
IN THE COUNTY OF THE SIXTH JUDICIAL CIRCUIT
IN AND FOR PINELLAS COUNTY, FLORIDA
Case No. ____________________________
________________________________
Plaintiff(s)
-vs-
________________________________
Defendant(s)
COMPLAINT FOR EVICTION AND DAMAGES
COUNT I – TO RECOVER POSSESSION
Plaintiff ________________________________, ______________________________ sues
Defendant ______________________________, ______________________________ and
alleges:
1. This is an action to evict a tenant from real property in Pinellas, Florida
2. Plaintiff owns the following described real property in the county:
________________________________________________________________________
________________________________________________________________________
3. Defendant has possession of the property under an oral written agreement to
pay rent of $_________________ payable weekly monthly other __________.
A copy of the written agreement, if any, is attached as Exhibit “A”.
4. Defendant failed to pay rent due ______________________________.
5. Plaintiff served defendant with a notice on ___________________ to pay the rent or
deliver possession, but the defendant refuses to do either. A copy of the notice is
attached as Exhibit “B”.
WHEREFORE, plaintiff demands judgment for possession of the property against the defendant.
Form 5a
COUNT II – FOR DAMAGES
Plaintiff sues defendant and states:
6. Plaintiff restates those allegations contained in paragraphs 1 through 5 above.
7. Defendant owes Plaintiff $_________________________ that is due with interest for
(insert past due rent amount)
the period of __________________________________________________________.
(insert dates of rental payments Tenant failed to make)
WHEREFORE, Plaintiff demand judgment for damages and costs against defendant(s).
Signature: ___________________________
Name (print): ________________________
Address: ____________________________
City, State, Zip Code: __________________
Telephone: __________________________
Approved for use under rule 10-2.1(a) of
The Rules Regulating The Florida Bar
The Florida Bar 2010
This form was completed with the assistance of:
Name: _________________________________
Address: _______________________________
Telephone Number: ______________________
(Form 1.997 Civil Rules of Procedure 9/2020)
CIRCUIT COURT, PINELLAS COUNTY, FLORIDA
CIVIL DIVISION
CIVIL COVER SHEET
FORM 1.997 The civil cover sheet and the information contained herein neither replace nor supplement the filing and
service of pleadings or other papers as required by law. This form shall be filed by the plaintiff or petitioner for the use of
the Clerk of Court for the purpose of reporting judicial workload data pursuant to Florida Statutes section 25.075. (See
instructions for completion.)
I. CASE STYLE
Plaintiff _________________________________
________________________________________
Vs.
Defendant _______________________________
________________________________________
Case No.:
Section:
II. AMOUNT OF CLAIM: Please indicate the estimated amount of the claim rounded to the nearest dollar. The estimated
amount of the claim is requested for data collection and clerical processing purposes only. The amount of the claim
shall not be used for any other purpose.
$8,000 or less
$50,001 - $75,000
$8,001 - $30,000
$75,001 - $100,000
$30,001 - $50,000
Over $100,000
III. TYPE OF CASE (If the case fits more than one type of case, select the most definitive category.)
If the most descriptive label is a subcategory (is indented under a broader category),
place an x in both the main category and subcategory boxes.
Condominium
Contracts and indebtedness
Eviction/Delinquent Tenant
Eminent domain
Auto negligence
Negligence—other
Business governance
Business torts
Environmental/Toxic tort
Third party indemnification
Construction defect
Mass tort
Negligent security
Nursing home negligence
Premises liability—commercial
Premises liability—residential
Products liability
Real property/Mortgage foreclosure
Commercial foreclosure $0 - $50,000
Commercial foreclosure $50,001 - $249,999
Commercial foreclosure $250,000 or more
Homestead residential foreclosure $0 - $50,000
Homestead residential foreclosure $50,001 - $249,999
Homestead residential foreclosure $250,000 or more
Non-homestead residential foreclosure $0 - $50,000
Non-homestead residential foreclosure $50,001 - $249,999
Non-homestead residential foreclosure $250,000 or more
Other real property actions $0 - $50,000
Other real property actions $50,001 - $249,999
Other real property actions $250,000 or more
Professional malpractice
Malpractice—business
Malpractice—medical
Malpractice—other professional
(Form 1.997 Civil Rules of Procedure 9/2020)
Other
Antitrust/Trade regulation
Business transactions
Constitutional challenge—statute or ordinance
Constitutional challenge—proposed amendment
Corporate trusts
Discrimination—employment or other
Insurance claims
Intellectual property
Libel/Slander
Shareholder derivative action
Securities litigation
Trade secrets
Trust litigation
County Civil
Civil
Real property/Mortgage foreclosure
Replevins
Evictions
Residential Evictions
Non-residential Evictions
Other Civil (non-monetary)
III. REMEDIES SOUGHT (check all that apply):
monetary;
nonmonetary declaratory or injunctive relief;
punitive
IV. NUMBER OF CAUSES OF ACTION: [ ]
(specify)
V. IS THIS CASE A CLASS ACTION LAWSUIT?
yes
no
VI. HAS NOTICE OF ANY KNOWN RELATED CASE BEEN FILED?
no
yes If “yes,” list all related cases by name, case number, and court.
VII. IS JURY TRIAL DEMANDED IN COMPLAINT?
yes
no
I CERTIFY that the information I have provided in this cover sheet is accurate to the best of my knowledge and belief.
Signature Fla. Bar #
Attorney or party (Bar # if attorney)
(type or print name) Date
CO CIV 87
,17+(&2817<&28572)7+(6,;7+-8'&,$/&,5&8,7
,1$1')253,1(//$6&2817<)/25,'$
PLAINTIFF(S)
____________________________/
VS.
DEFENDANT (S)
____________________________/
$87+25,=$7,212)3523(57<0$1$*(5
72:+20,70$<&21&(51
_____________________________________
is being retained by
_____________________________________, Landlord, as Property
Manager for the residential property located at
_______________________________________________________
_______________________________________________________.
The Property Manager is hereby authorized by the undersigned Landlord to act
on their behalf regarding uncontested residential tenant evictions. This
authorization must be limited to the completion, signing and filing of the
pleadings necessary to evict a tenant for the nonpayment of rent.
I hereby swear or affirm under the penalty of perjury that the foregoing is true
and accurate.
________________________________
Signature of Landlord
________________________________
Printed Name of Landlord
Fla. R. Civ. Pro. Form 1.923 rev. Feb. 2021
IN THE COUNTY COURT OF THE SIXTH JUDICIAL CIRCUIT
IN AND FOR PINELLAS COUNTY, FLORIDA
Case No.___________________
____________________________________
Plaintiff(s)
v.
____________________________________
Defendant(s)
EVICTION SUMMONS / RESIDENTIAL
FORM 1.923
TO: ____________________________
DEFENDANT(S)
_________________________________
_________________________________
_________________________________
PLEASE READ CAREFULLY
You are being sued by PLAINTIFF(S) to require you to MOVE OUT of the place where
you are living [PROPERTY ADDRESS: ______________________________________________]
for the reasons given in the attached complaint.
You are entitled to a trial to determine whether you can be required to move, but you MUST
do ALL of the things listed below. You must do them within 5 DAYS (not including Saturday,
Sunday, or any legal holiday) after the date these papers were given to you or to a person who lives
with you or were posted at your home.
THE THINGS YOU MUST DO ARE AS FOLLOWS:
(1) Write down the reason(s) why you think you should not be forced to move. The written
reason(s) must be given to the PINELLAS COUNTY CLERK OF THE CIRCUIT COURT, 315
Court Street, Room 170, Clearwater, Florida 33756.
(2) Mail or give a copy of your written reason(s) to: Plaintiff or Plaintiff’s Attorney whose
name and address is:
__________________________________________________________________________
__________________________________________________________________________
(3) Pay to the PINELLAS COUNTY CLERK OF THE CIRCUIT COURT the amount of
rent that the attached complaint claims to be due and any rent that becomes due until the lawsuit is
over. If you believe that the amount claimed in the complaint is incorrect, you should file with the
clerk of the court a motion to have the court determine the amount to be paid. If you file a motion,
you must attach to the motion any documents supporting your position and mail or give a copy of the
motion to the plaintiff/plaintiff’s attorney. Monies deposited into the registry of the court must be
in the form of cash, cashier’s check, or money order. A clerk’s fee of 3% on the first $500.00,
and 1.5% on each subsequent $100.00 must be paid in addition to the monies deposited.
Fla. R. Civ. Pro. Form 1.923 rev. Feb. 2021
(4) If you file a motion to have the court determine the amount of rent to be paid to the clerk
of the court, you must IMMEDIATELY contact the office of the judge to whom the case is assigned
to schedule a hearing to decide what amount should be paid to the clerk of the court while the lawsuit
is pending.
IF YOU DO NOT DO ALL OF THE THINGS SPECIFIED ABOVE WITHIN 5
WORKING DAYS AFTER THE DATE THAT THESE PAPERS WERE GIVEN TO YOU OR
TO A PERSON WHO LIVES WITH YOU OR WERE POSTED AT YOUR HOME, YOU
MAY BE EVICTED WITHOUT A HEARING OR FURTHER NOTICE
(5) If the attached complaint also contains a claim for money damages (such as unpaid rent),
you must respond to that claim separately. You must write down the reasons why you believe that
you do not owe the money claimed. The written reasons must be given to the clerk of the court at the
address specified in paragraph (1) above, and you must mail or give a copy of your written reasons
to the plaintiff/plaintiff’s attorney at the address specified in paragraph (2) above. This must be done
within 20 DAYS after the date these papers were given to you or to a person who lives with you. This
obligation is separate from the requirement of answering the claim for eviction within 5 working days
after these papers were given to you or to a person who lives with you or were posted at your home.
If you are a person with a disability who needs any accommodation in order
to participate in this proceeding, you are entitled, at no cost to you, to the
provision of certain assistance. Please contact:
Pinellas County Office of Human Rights
400 S. Ft. Harrison Ave., Ste. 500
Clearwater, FL 33756
Phone: 727.464.4062 V/TDD
Or 711 for the hearing impaired
Contact should be initiated at least 7 days before your scheduled court
appearance, or immediately upon receiving this notification if the time before the
scheduled appearance is less than 7 days; if you are hearing or voice impaired,
call 711.
THE STATE OF FLORIDA:
To Each Sheriff of the State:
YOU ARE COMMANDED to serve this SUMMONS and a copy of the COMPLAINT in this
lawsuit on the above-named DEFENDANT(S).
DATED on ___________________
KEN BURKE, CPA
Pinellas County Clerk of the Circuit Court
315 Court Street, Room 170
Clearwater, FL 33756
(727) 464-7000
BY: __________________________________
As Deputy Clerk
Fla. R. Civ. Pro. Form 1.923 rev. Feb. 2021
If you cannot afford an attorney, you may be eligible for free legal assistance by contacting
Bay Area Legal Aid line at (800) 625-2257; Community Law Program (south Pinellas County
residents only) at (727) 582-7402; or Gulfcoast Legal Services at (727) 821-0726. If you do not
qualify for free legal assistance or do not know an attorney, you may make an appointment to speak
with an attorney for $1.00 per minute in 15 minute increments at the Self Help Center online @
https://www.mypinellasclerk.org/selfhelp or by contacting (727) 464-5150 for north Pinellas County
residents or (727) 582-7941 for south Pinellas County residents. You may also contact the Clearwater
Bar Attorney Referral Service at (727) 461-4880; the St. Petersburg Bar Association Lawyer Referral
Service at https://www.stpetebar.com/page/findanatty; or the Florida Bar Attorney Referral Service
at (800) 342-8011.
NOTIFICACION DE DESALOJO/RESIDENCIAL
A DEMANDADO(S)
SIRVASE LEER CON CUIDADO
Usted esta siendo demandado por DEMANDANTE para exigirle que desaloje el lugar donde
reside por los motivos que se expresan en la demanda adjunta.
Usted tiene derecho a ser sometido a juicio para determinar si se le puede exigir que se mude,
pero ES NECESARIO que haga TODO lo que se le pide a continuacion en un plazo de 5 DIAS (no
incluidos los sabados, domingos, ni dias feriados) a partir de la fecha en que estos documentos se le
entregaron a usted o a una persona que vive con usted, o se colocaron en su casa.
USTED DEBERA HACER LO SIGUIENTE:
(1) Escribir el (los) motivo(s) por el (los) cual(es) cree que no se le debe obligar a mudarse.
El (Los) motivo(s) debera(n) entregarse por escrito al secretario del tribunal a: PINELLAS
COUNTY CLERK OF THE CIRCUIT COURT, 315 Court Street, Room 170, Clearwater, Florida
33756.
(2) Enviar por correo o darle su(s) motivo(s) por escrito a:
Demandante/Abogrado del Demandante
__________________________________________________________________________
__________________________________________________________________________
(3) Pagarle al secretario del tribunal el monto del alquiler que la demanda adjunta reclama
como adeudado, asi como cualquier alquiler pagadero hasta que concluya el litigio. Si usted considera
que el monto reclamado en la demanda es incorrecto, debera presentarle al secretario del tribunal una
mocion para que el tribunal determine el monto que deba pagarse. Si usted presenta una mocion,
debera adjuntarle a esta cualesquiera documentos que respalden su posicion, y enviar por correo o
entregar una copia de la misma al demandante/abogado del demandante. El dinero depositado en el
registro de la corte debe ser en efectivo, cheque de caja o giro postal. Además del dinero
depositado, se debe pagar una tarifa de secretario del 3% sobre los primeros $ 500,00 y del
1,5% sobre cada $ 100,00 subsiguientes.
(4) Si usted presenta una mocion para que el tribunal determine el monto del alquiler que deba
pagarse al secretario del tribunal, debera comunicarse de inmediato con la oficina del juez al que se
le haya asignado el caso para que programe una audiencia con el fin de determinar el monto que deba
pagarse al secretario del tribunal mientras el litigio este pendiente.
Fla. R. Civ. Pro. Form 1.923 rev. Feb. 2021
SI USTED NO LLEVA A CABO LAS ACCIONES QUE SE ESPECIFICAN
ANTERIORMENTE EN UN PLAZO DE 5 DIAS LABORABLES A PARTIR DE LA FECHA EN
QUE ESTOS DOCUMENTOS SE LE ENTREGARON A USTED O A UNA PERSONA QUE
VIVE CON USTED, O SE COLOQUEN EN SU CASA, SE LE PODRA DESALOJAR SIN
NECESIDAD DE CELEBRAR UNA AUDIENCIA NI CURSARSELE OTRO AVISO
(5) Si la demanda adjunta tambien incluye una reclamacion por danos y perjuicios pecunarios
(tales como el incumplimiento de pago del alquiler), usted debera responder a dicha reclamacion por
separado. Debera exponer por escrito los motivos por los cuales considera que usted no debe la suma
reclamada, y entregarlos al secretario del tribunal en la direccion que se especifica en el parrafo (1)
anterior, asi como enviar por correo o entregar una copia de los mismos al demandante/abogado del
demandante en la direccion que se especifica en el parrafo (2) anterior. Esto debera llevarse a cabo
en un plazo de 20 dias a partir de la fecha en que estos documentos se le entregaron a usted o a una
persona que vive con usted. Esta obligacion es aparte del requisito de responder a la demanda de
desalojo en un plazo de 5 dias a partir de la fecha en que estos documentos se le entregaron a usted o
a una persona que vive con usted, o se coloquen en su casa.
Si usted es una persona minusválida que necesita algún acomodamiento
para poder participar en este procedimiento, usted tiene derecho, sin tener gastos
propios, a que se le provea cierta ayuda. Tenga la amabilidad de ponerse en
contacto con
Pinellas County Office of Human Rights
400 S. Ft. Harrison Ave., Ste. 500
Clearwater, FL 33756
Phone: 727.464.4062 V/TDD
O 711 para personas con discapacidad del oído o de la voz
por lo menos 7 días antes de la cita fijada para su comparecencia en los
tribunales, o inmediatamente después de recibir esta notificación si el tiempo
antes de la comparecencia que se ha programado es menos de 7 días; si usted tiene
discapacitación del oído o de la voz, llame al 711.
CITATION D’EVICTION/RESIDENTIELLE
A DEFENDEUR (S)
LISEZ ATTENTIVEMENT
Vous etes poursuivi par PLAIGNNANT pour exiger que vous evacuez les lieux de votre
residence pour les raisons enumerees dans la plainte ci-dessous.
Vous avez droit a un proces pour determiner si vous devez demenager, mais vous devez, au
prealable, suivre les instructions enumerees ci-dessous, pendant les 5 JOURS (non compris le
samedi, le dimanche, ou un jour ferie) a partir de la date ou ces documents ont ete donnes a vous ou
a la personne vivant avec vous, ou ont ete affiches a votre residence.
LISTE DES INSTRUCTIONS A SUIVRE:
(1) Enumerer par ecrit les raisons pour lesquelles vous pensez ne pas avoir a demenager. Elles
doivent etre remises au clerc du tribunal a: PINELLAS COUNTY CLERK OF THE CIRCUIT
COURT, 315 Court Street, Room 170, Clearwater, Florida 33756.
Fla. R. Civ. Pro. Form 1.923 rev. Feb. 2021
(2) Envoyer ou donner une copie au:
Plaignnant/Avocat du Plaignant
__________________________________________________________________________
__________________________________________________________________________
(3) Payer au clerc du tribunal le montant des loyers dus comme etabli dans la plainte et le
montant des loyers dus jusqu’a la fin du proces. Si vous pensez que le montant etabli dans la plainte
est incorrect, vous devez presenter au clerc du tribunal une demande en justice pour determiner la
somme a payer. Pour cela vous devez attacher a la demande tous les documents soutenant votre
position et faire parvenir une copie de la demande au plaignant/avocat du plaignant. Lajan depoze
nan rejis la nan tribinal la dwe nan fòm lan nan lajan kach, chèk kesye a, oswa lòd lajan. Yon
frè grefye a 3% sou premye $ 500.00 a, ak 1.5% sou chak $ 100.00 ki vin apre yo dwe peye nan
adisyon a lajan yo depoze.
(4) Si vous faites une demande en justice pour determiner la somme a payer au clerc du
tribunal, vous devrez immediatement prevenir le bureau de juge qui presidera au proces pour fixer la
date de l’audience qui decidera quelle somme doit etre payee au clerc du tribunal pendant que le
proces est en cours.
SI VOUS NE SUIVEZ PAS CES INSTRUCTIONS A LA LETTRE DANS LES 5 JOURS
QUE SUIVENT LA DATE OU CES DOCUMENTS ONT ETE REMIS A VOUS OU A LA Florida
Rules of Civil Procedure February 2, 2021 190 PERSONNE HABITANT AVEC VOUS, OU ONT
ETE AFFICHES A VOTRE RESIDENCE, VOUS POUVEZ ETRE EXPULSES SANS AUDIENCE
OU SANS AVIS PREALABLE
(5) Si la plainte ci-dessus contient une demande pour dommages pecuniaires, tels des loyers
arrieres, vous devez y repondre separement. Vous devez enumerer par ecrit les raisons pour lesquelles
vous estimez ne pas devoir le montant demande. Ces raisons ecrites doivent etre donnees au clerc du
tribunal a l’adresse specifiee dans le paragraphe (1) et une copie de ces raisons donnee ou envoyee
au plaignant/avocat du plaignant a l’adresse specifiee dans le paragraphe (2). Cela doit etre fait dans
les 20 jours suivant la date ou ces documents ont ete presentes a vous ou a la personne habitant avec
vous. Cette obligation ne fait pas partie des instructions a suivre en reponse au proces d’eviction dans
les 5 jours suivant la date ou ces documents ont ete presentes a vous ou a la personne habitant avec
vous, ou affiches a votre residence.
Si ou se yon moun ki enfim ki bezwen akomodasyon pou w kab patisipe nan
pwosedi sa a, ou gen dwa, san ou pa bezwen peye okenn lajan, pou w jwenn yon
sèten èd. Tanpri kontakte [identify applicable court personnel by name],
Kòdonatris pwogram Lwa Ameriken pou Moun ki Enfim yo nan
Pinellas County Office of Human Rights
400 S. Ft. Harrison Ave., Ste. 500
Clearwater, FL 33756
Phone: 727.464.4062 V/TDD
Ou 711 si ou gen pwoblèm pou w tande byen oswa pou w pale klè
fè sa omwen 7 jou anvan dat ou gen randevou pou parèt nan Tribinal la,
oswa fè sa imedyatman apre ou fin resevwa konvokasyon an si dat ou gen pou w
Fla. R. Civ. Pro. Form 1.923 rev. Feb. 2021
parèt nan tribinal la mwens pase 7 jou; si ou gen pwoblèm pou w tande byen oswa
pou w pale klè, rele 711.
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Form 81
PINELLAS
IN THE COUNTY COURT, IN AND FOR
_________________________ COUNTY, FLORIDA
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YV MOTION FOR CLERK'S DEFAULT--
RESIDENTIAL EVICTION
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DEFAULT ----- RESIDENTIAL EVICTION
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PINELLAS
IN THE COUNTY COURT IN AND FOR PINELLAS COUNTY, FLORIDA
CIVIL DIVISION
__________________________________ , CASE NO. ___________________
(
Insert name of Landlord) DIVISION: ___________________
Plaintiff,
vs.
__________________________________
(
Insert name of Tenant)
Defendant,
MOTION FOR &2857 DEFAULT
Plaintiff moves for entry of a default by the Court because the Defendant ______________________
_________________________________ failed to place the rent money into the Registry of the Court
as required by law.
6LJQDWXUH ________________________
Landlord/Plaintiff
DEFAULT
A default is entered in this action against the Defendant, BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB
named in foregoing Motion for failure to deposit the rent money into the Registry of the Court as required
by law.
DONE AND ORDERED in Pinellas County, Florida this _____ day of___________________,
____________________________________________
County Judge
Form CO CIV 78
IN THE COUNTY COURT, IN AND FOR
_______________________________ COUNTY, FLORIDA
CASE NO.: ______________________________
(insert case number assigned
by Clerk of the Court)
________________________________________ ,
(Insert name of Landlord)
Plaintiff,
vs. MOTION FOR DEFAULT FINAL
JUDGMENT-RESIDENTIAL EVICTION
_______________________________________
(Insert name of Tenant)
Defendant.
_________________________________________ /
Plaintiff asks the court to enter a Default
Final Judgment against _________________________
[name]
Defendant, for residential eviction and says:
1. Plaintiff filed a complaint alleging grounds for residential eviction of Defendant.
2. A Default was entered by the Clerk of this Court on____________________________
[date]
WHEREFORE, Plaintiff asks this Court to enter a Final Judgment For Residential Eviction
against Defendant.
6LJQDWXUH____________________________________
Name ______________________________
Address ___________________________
____________________________________
Telephone Number _________________
cc: ______________________________________
(Insert name and address of Tenant)
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PINELLAS
5HVLGHQWLDO(YLFWLRQIRU1RQ3D\PHQWRI5HQWForm #10
IN THE COUNTY COURT OF THE SIXTH JUDICIAL CIRCUIT
IN AND FOR PINELLAS COUNTY, FLORIDA
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MOTION TO SET CAUSE FOR NON-JURY TRIAL
FINAL JUDGMENT RESIDENTIAL EVICTION
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ORDER SETTING CAUSE FOR NON-JURY TRIAL
FINAL JUDGMENT RESIDENTIAL EVICTION
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If you are a person with a disability who needs any accommodation in order to
participate in this proceeding, you are entitled, at no cost to you, to the provision
of certain assistance. Please contact the Human Rights Office, 400 S. Ft. Harrison
Ave., Ste. 300, Clearwater, FL 33756, (727)464-4062 (V/TDD) at least 7 days
before your scheduled court appearance, or immediately upon receiving this
notification if the time before the scheduled appearance is less than 7 days; if you
are hearing or voice impaired, call 711.
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PINELLAS
Revised by Clerk 11/2020
IN THE COUNTY COURT OF THE SIXTH JUDICIAL CIRCUIT
IN AND FOR PINELLAS COUNTY, FLORIDA
Case no. ______________________
______________________________
Plaintiff
Vs.
______________________________
Defendant(s)
WRIT OF POSSESSION
THE STATE OF FLORIDA:
TO ALL AND SINGULAR THE SHERIFFS OF THE STATE:
YOU ARE COMMANDED to remove Defendant(s) _____________________________________________
from the following property in Pinellas County, Florida AFTER A 24 HOUR NOTICE HAS BEEN
CONSPICUOUSLY POSTED ON THE PREMISES:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
and to put ____________________________________________________________________________
in full possession thereof.
WITNESS my hand and seal of the Court on ____________ day of ________________________, 20____.
KEN BURKE, CPA
Pinellas County Clerk of the Circuit Court
315 Court Street, Room 170
Clearwater, FL 33756
By: _________________________________
Deputy Clerk
(SEAL)
Plaintiff(s) – or – Attorney(s) Name and Address:
____________________________________
____________________________________
____________________________________
Phone #: _____________________________
Fla. R. Civ. Pro. Form 1.920 rev. Mar. 2021
IN THE COUNTY COURT OF THE SIXTH JUDICIAL CIRCUIT
IN AND FOR PINELLAS COUNTY, FLORIDA
Case No.___________________
____________________________________
Plaintiff(s)
v.
____________________________________
Defendant(s)
SUMMONS
(PERSONAL SERVICE ON A NATURAL PERSON)
THE STATE OF FLORIDA:
To each Sheriff of the State:
YOU ARE COMMANDED to serve this summons and a copy of the complaint or petition in this
action on:
Defendant: ________________________
Address __________________________
City, State, Zip _____________________
TO THE DEFENDANT(S):
YOU ARE REQUIRED to mail or take a copy of your WRITTEN ANSWER AND
DEFENSES to the attached COMPLAINT or PETITION to Plaintiff or Plaintiff's attorney
whose name and address is_______________________________________________________
_____________________________________________________________________________,
within 20 DAYS after service of this summons on you, exclusive of the day of service, AND to file
the original of the defenses with the CLERK OF THE CIRCUIT COURT, 315 Court Street,
Room 170, Clearwater, Florida 33756, either before service on Plaintiff or Plaintiff’s attorney or
immediately thereafter. If you fail to do so, a default will be entered against you for the relief
demanded in the complaint or petition.
DATED on ___________________
KEN BURKE, CPA
Pinellas County Clerk of the Circuit Court
315 Court Street, Room 170
Clearwater, FL 33756
(727) 464-7000
BY: __________________________________
As Deputy Clerk
IMPORTANT
A lawsuit has been filed against you. You have 20 calendar days after this summons is served
on you to file a written response to the attached complaint with the clerk of this court. A phone call
Fla. R. Civ. Pro. Form 1.920 rev. Mar. 2021
will not protect you. Your written response, including the case number given above and the names of
the parties, must be filed if you want the court to hear your side of the case. If you do not file your
response on time, you may lose the case, and your wages, money, and property may thereafter be
taken without further warning from the court. There are other legal requirements. You may want to
call an attorney right away. If you do not know an attorney, you may call an attorney referral service
or a legal aid office (listed in the phone book).
If you choose to file a written response yourself, at the same time you file your written
response to the court you must also mail or take a copy of your written response to the
Plaintiff/Plaintiff’s Attorney.
If you are a person with a disability who needs any accommodation in order
to participate in this proceeding, you are entitled, at no cost to you, to the
provision of certain assistance. Please contact:
Pinellas County Office of Human Rights
400 S. Ft. Harrison Ave., Ste. 500
Clearwater, FL 33756
Phone: 727.464.4062 V/TDD
Or 711 for the hearing impaired
Contact should be initiated at least 7 days before your scheduled court
appearance, or immediately upon receiving this notification if the time before the
scheduled appearance is less than 7 days; if you are hearing or voice impaired,
call 711.
If you cannot afford an attorney, you may be eligible for free legal assistance by contacting
Bay Area Legal Aid line at (800) 625-2257; Community Law Program (south Pinellas County
residents only) at (727) 582-7402; or Gulfcoast Legal Services at (727) 821-0726. If you do not
qualify for free legal assistance or do not know an attorney, you may make an appointment to speak
with an attorney for $1.00 per minute in 15 minute increments at the Self Help Center online @
https://www.mypinellasclerk.org/selfhelp or by contacting (727) 464-5150 for north Pinellas County
residents or (727) 582-7941 for south Pinellas County residents. You may also contact the Clearwater
Bar Attorney Referral Service at (727) 461-4880; the St. Petersburg Bar Association Lawyer Referral
Service at https://www.stpetebar.com/page/findanatty; or the Florida Bar Attorney Referral Service
at (800) 342-8011.
IMPORTANTE
Usted ha sido demandado legalmente. Tiene 20 dias, contados a partir del recibo de esta
notificacion, para contestar la demanda adjunta, por escrito, y presentarla ante este tribunal. Una
llamada telefonica no lo protegera. Si usted desea que el tribunal considere su defensa, debe presentar
su respuesta por escrito, incluyendo el numero del caso y los nombres de las partes interesadas. Si
usted no contesta la demanda a tiempo, pudiese perder el caso y podria ser despojado de sus ingresos
y propiedades, o privado de sus derechos, sin previo aviso del tribunal. Existen otros requisitos
legales. Si lo desea, puede usted consultar a un abogado inmediatamente. Si no conoce a un abogado,
puede llamar a una de las oficinas de asistencia legal que aparecen en la guia telefonica.
Fla. R. Civ. Pro. Form 1.920 rev. Mar. 2021
Si desea responder a la demanda por su cuenta, al mismo tiempo en que presenta su respuesta
ante el tribunal, debera usted enviar por correo o entregar una copia de su respuesta a la persona
denominada abajo como “Plaintiff/Plaintiff’s Attorney” (Demandante o Abogado del Demandante).
Si usted es una persona minusválida que necesita algún acomodamiento
para poder participar en este procedimiento, usted tiene derecho, sin tener gastos
propios, a que se le provea cierta ayuda. Tenga la amabilidad de ponerse en
contacto con
Pinellas County Office of Human Rights
400 S. Ft. Harrison Ave., Ste. 500
Clearwater, FL 33756
Phone: 727.464.4062 V/TDD
O 711 para personas con discapacidad del oído o de la voz
por lo menos 7 días antes de la cita fijada para su comparecencia en los
tribunales, o inmediatamente después de recibir esta notificación si el tiempo
antes de la comparecencia que se ha programado es menos de 7 días; si usted tiene
discapacitación del oído o de la voz, llame al 711.
IMPORTANT
Des poursuites judiciares ont ete entreprises contre vous. Vous avez 20 jours consecu-tifs a
partir de la date de l’assignation de cette citation pour deposer une reponse ecrite a la plainte cijointe
aupres de ce tribunal. Un simple coup de telephone est insuffisant pour vous proteger. Vous etes
obliges de deposer votre reponse ecrite, avec mention du numero de dossier ci-dessus et du nom des
parties nommees ici, si vous souhaitez que le tribunal entende votre cause. Si vous ne deposez pas
votre reponse ecrite dans le relai requis, vous risquez de perdre la cause ainsi que votre salaire, votre
argent, et vos biens peuvent etre saisis par la suite, sans aucun preavis ulterieur du tribunal. Il y a
d’autres obligations juridiques et vous pouvez requerir les services immediats d’un avocat. Si vous
ne connaissez pas d’avocat, vous pourriez telephoner a un service de reference d’avocats ou a un
bureau d’assistance juridique (figurant a l’annuaire de telephones).
Si vous choisissez de deposer vous-meme une reponse ecrite, il vous faudra egale-ment, en
meme temps que cette formalite, faire parvenir ou expedier une copie de votre reponse ecrite au
“Plaintiff/Plaintiff’s Attorney” (Plaignant ou a son avocat) nomme ci-dessous.
Si vous êtes une personne handicapée qui a besoin de mesures d'adaptation
pour participer à cette procédure, vous avez droit, sans frais pour vous, à une
certaine assistance. Veuillez contacter
Pinellas County Office of Human Rights
400 S. Ft. Harrison Ave., Ste. 500
Clearwater, FL 33756
Phone: 727.464.4062 V/TDD
Ou 711 si vous êtes malentendant ou avez un trouble de la parole
Fla. R. Civ. Pro. Form 1.920 rev. Mar. 2021
au moins 7 jours avant votre comparution prévue au tribunal, ou
immédiatement après avoir reçu cette notification si le délai avant la comparution
prévue est inférieur à 7 jours; si vous êtes malentendant ou avez un trouble de la
parole, appelez le 711.
ENPÒTAN
Pwosedi legal yo te pran kont ou. Ou gen 20 jou konsekitif ki soti nan dat konklizyon sa a
pou ou ranpli yon repons alekri pou plent sa a nan tribinal sa a. Yon apel telefon ki senp se pa ase
pou pwoteje ou. Ou oblije ranpli repons alekri ou a, ak nimewo a dosye pi wo a ak non pati yo ki te
nonmen isit la, si ou vle tribinal la tande ka w la. Si ou pa ranpli repons alekri ou nan rele egzije a, ou
riske pedi koz la ak sale ou, lajan ou, ak pwopriyete ou yo ka mete men sou pita, san okenn lot avi
nan tribinal la. Gen lot obligasyon legal epi ou ka mande sevis imedya yon avoka. Si ou pa konnen
yon avoka, ou ka rele yon sèvis referans avoka oswa yon biwo ed legal (ki nan lis nan anye telefon).
Si ou chwazi pou ou soumet yon repons alekri tet ou, ou pral bezwen tou voye oswa voye yon
kopi repons ekri ou nan fòm sa a an menm tan an tankou fomalite sa a “Avoka Pleyan/ Pwokire a”
(Pleyan oswa avoka li) non anba a.
Si ou se yon moun ki enfim ki bezwen akomodasyon pou w kab patisipe nan
pwosedi sa a, ou gen dwa, san ou pa bezwen peye okenn lajan, pou w jwenn yon
sèten èd. Tanpri kontakte [identify applicable court personnel by name],
Kòdonatris pwogram Lwa Ameriken pou Moun ki Enfim yo nan
Pinellas County Office of Human Rights
400 S. Ft. Harrison Ave., Ste. 500
Clearwater, FL 33756
Phone: 727.464.4062 V/TDD
Ou 711 si ou gen pwoblèm pou w tande byen oswa pou w pale klè
fè sa omwen 7 jou anvan dat ou gen randevou pou parèt nan Tribinal la,
oswa fè sa imedyatman apre ou fin resevwa konvokasyon an si dat ou gen pou w
parèt nan tribinal la mwens pase 7 jou; si ou gen pwoblèm pou w tande byen oswa
pou w pale klè, rele 711.
IN THE COUNTY COURT, IN AND FOR
_____________________________ COUNTY, FLORIDA
CASE NO.:______________________________
(insert case number assigned
by Clerk of the Court)
________________________________________
(Insert name of Landlord)
Plaintiff,
vs. AFFIDAVIT OF DAMAGES
________________________________________
(Insert name of Tenant)
Defendant.
________________________________________
STATE OF FLORIDA )
COUNTY OF )
BEFORE ME, the undersigned authority, personally appeared __________________________________ ,
[name]
who being first duly sworn, says:
1. I am ___ the Plaintiff or ___ the Plaintiffs agent (check appropriate response) in this case
and am authorized to make this affidavit.
2. This affidavit is based on my own personal knowledge.
3. Defendant has possession of the property which is the subject of this eviction under an
agreement to pay rent of $ __________________ per _______________________________________________
[rental amount] [week, month, or other payment period]
4. Defendant has not paid the rent due since ___________________________________________
[date of payment tenant has failed to make]
5. Defendant owes Plaintiff $ __________________as alleged in the complaint plus interest.
[past due rent amount]
Approved for use under rule 10-2.1(a) of
the Rules Regulating The Florida
The Flori
da Bar 2010
FORM 80
PINELLAS
6. Defendant owes Plaintiff $ ______________________ as alleged in the complaint plus interest
[amount of other damages]
Signature_______________________________________________
Pritned Name__________________________________________
Sworn and subscribed before me on __________________________ by ____________________________________, who
[date] [name]
____ is personally known to me/ ____ produced ___________________________________ as identification, and who
[document]
____ did/ ____ did not take an oath.
__________________________________________
NOTARY PUBLIC-STATE OF FLORIDA
Name: _____________________________________
Commission No.: ____________________________
My Commission Expires: ______________________
I CERTIFY that I _______ mailed,_______ telefaxed and mailed, or _______ hand delivered a copy of this
motion and attached affidavit to the Defendant at _____________________________________________________
_____________________________________________________________________________________________
[insert address at which tenant was served and telefax number if sent by telefax]
This form was
completed with
the assistance of
Name:
Address:
Telephone Number:
FORM 80
IN THE COUNTY COURT, IN AND FOR
___________________________ COUNTY, FLORIDA
CASE NO.: ___________________________
______________________________________ ,
(Insert name of Landlord)
Plaintiff,
vs. MOTION FOR CLERK'S DEFAULT –
DAMAGES (RESIDENTIAL EVICTION)
______________________________________ ,
(Insert name of Tenant)
Defendant.
_____________________________________ /
Plaintiff asks the clerk to enter a default against __________________________ _____________________ ,
[Tenant name(s)]
Defendant, for damages for failin
g to respond as required by law to plaintiffs complaint for damages.
Signature: ______________________________________
Name ______________
______
_________________
Address ___________________________________
__________________________________________
Telephone Number __________________________
DEFAULT - DAMAGES
A default is entered in this action against the Defendant for damages for failure to respond
as required by law.
DATE:____________________________ CLERK OF THE COURT
By: __________________________________
Deputy Clerk
cc: ______________________________________
(Insert name of Landlord)
______________________________________
(Insert name and address of Tenant)
This form was completed
Approved for use under rule 10-2.1(a) of with the assistance of:
the Rules Regulating The Florida Bar Name:
Address:
The Florida Bar
2011 Telephone
Numb
er:
F
ORM 77
PINELLAS
IN THE COUNTY COURT, IN AND FOR
____________________________ COUNTY, FLORIDA
CASE NO.: __________________________________
(insert case number assigned
by Clerk of the Court)
___________________________________________ ,
(Insert name of Landlord)
Plaintiff,
vs. MOTION FOR DEFAULT FINAL
JUDGMENT - DAMAGES
(RESIDENTIAL
EVICTION)
___________________________________________ ,
(Insert name of Tenant)
___________________________________________ /
Defendant.
Plaintiff asks the court to enter a Default Final Judgment against ________________________________ ,
Defendant, for damages, and says: [name]
1. Plaintiff filed a complaint for damages against the Defendant.
2. Defendant has failed to timely file an answer and a Default has been entered by the
Clerk of this Court on ______________________________ .
[date]
3. In support of this Motion, Plaintiff submits the attached Affidavit of Damages.
WHEREFORE, Plaintiff asks this Court to enter a Final Judgment against Defendant.
I CERTIFY that I ____ mailed, ____ telefaxed and mailed, or ____ hand delivered-a copy of this
motion and attached affidavit to the Defendant at ___________________________________________________
__________________________________________________________________________________________
[insert address at which tenant was served and telefax number if sent by telefax]
Signature: ______________________________________
Name ____________________________
Address __________________________
_________________________________
Telephone Number _________________
This form was completed
Approved for use under rule 10-2.1(a) of with the assistance of:
the Rules Regulating The Florida Bar Name:
Address:
The Florida Bar 2011 Telephone Number:
FORM 79
PINELLAS
Form 16 - 3/2011 Residential Eviction and Damages for Non-Payment of Rent Form #16
IN THE COUNTY COURT OF THE SIXTH JUDICIAL CIRCUIT
IN AND FOR PINELLAS COUNTY, FLORIDA
Reference No: ______________________ UCN: 5220 CC XXCOCO
_______________________________
Plaintiff(s)
vs.
_______________________________
Defendant(s)
MOTION TO SET CAUSE FOR NON-JURY TRIAL
FINAL JUDGMENT FOR DAMAGES – COUNT II
Plaintiff(s) asks the court to set the above-styled cause for a non-jury trial on the Final Judgment for
Damages – Count II.
Date: ____________________
Signat ure of Plaintiff(s)
Print Name:
Address:
City, State, Zip:
Telephone No:
ORDER SETTING CAUSE FOR NON-JURY TRIAL
FINAL JUDGMENT COUNT II
The Court having reviewed the file and pleadings therein and being otherwise fully advised in the premises,
it is therefore
ORDERED AND ADJUDGED that the non-jury trial on the Final Judgment for Damages – Count II is set
for a hearing before Judge__________________________ on {date} ______________________, at
{time} ____________, in Room ____________ of the Pinellas County Courthouse located at:
_____________________________________________________________________________________________.
________hour(s)/________minutes have been reserved for this hearing.
DONE AND ORDERED in Pinellas County, Florida on the _______ day of _____________, 20_______.
_ __________________________________
cc: COUNTY COURT JUDGE
Plaintiff(s) __________________________
Address ____________________________
City, State, Zip_______________________
Defendant(s) ________________________
Address ____________________________
City, State, Zip_______________________
If you are a person with a disability who needs any accommodation in order
to participate in this proceeding, you are entitled, at no cost to you, to the
provision of certain assistance. Please contact the Human Rights Office, 400 S.
Ft. Harrison Ave., Ste. 300, Clearwater, FL 33756, (727)464-4062 (V/TDD) at
least 7 days before your scheduled court appearance, or immediately upon
receiving this notification if the time before the scheduled appearance is less
than 7 days; if you are hearing or voice impaired, call 711.
IN THE COUNTY COURT, IN AND FOR
___________________________________
(insert county in which rental property
is located)
COUNTY, FLORIDA
CASE NO.: _________________________
(insert case number assigned
by Clerk of the Court)
______________________________ ,
(Insert name of Landlord)
Plaintiff,
vs. FINAL JUDGMENT - DAMAGES
______________________________ ,
(Insert name of Tenant)
Defendant.
______________________________ /
THIS ACTION came before the Court upon Plaintiffs Complaint for unpaid rent. On the
evidence presented, it is
ADJUDGED that Plaintiff, ____________________________ recover from Defendant,
(insert Landlord's name)
_______________________________ , the sum of $ _____________ with costs in the sum of
(insert Tenant's name)
$___________ , making a total of $ ___________ , that shall bear interest at the rate of % a
year for which let execution now issue.
ORDERED in ____________________________ , _____________________________
(insert city in which court is located) (insert county in which court is located)
COUNTY; FLORIDA on _______________________________ , 20 _____ .
__________________________________
(County/Circuit) Judge
cc: ________________________________
(Insert name of Landlord)
____________________________________
(Insert name of Tenant)
This form was completed
with the assistance of:
Name:
Approved for use under rule 10-1.1(b) of Address:
the Rules Regulating The Florida Bar Telephone Number:
The Florida Bar 2010
FORM 9
PINELLAS
IN THE COUNTY COURT OF THE SIXTH JUDICIAL CIRCUIT
IN AND FOR PINELLAS COUNTY, FLORIDA
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BBBBBBBBBBBBBBBBBBBBBBBBBB
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Revised by Clerk 11/2020
IN THE CIRCUIT COURT OF THE 6
TH
JUDICIAL CIRCUIT,
IN AND FOR PINELLAS COUNTY, FLORIDA
Reference No: ______________________
______________________________
Plaintiff(s)
vs.
______________________________
Defendant(s)
DISCLOSURE FROM NONLAWYER
______________________________ told me that he/she is a nonlawyer and may not give me legal
advice, cannot tell me what my rights or remedies are, cannot tell me how to testify in court, and cannot
represent me in court.
______________________________ told me that he/she may only type the factual information
provided by me in writing into the blanks on the form. Except for typing, ________________________
may not tell me what to put in the form and may not complete the form for me. However, if using a
form approved by the Supreme Court of Florida, _______________________________ may ask me
factual questions to fill in the blanks on the form and may tell me how to file the form.
(Choose one only)
_____ I can read English.
_____ I cannot read English, but this disclosure was read to me by __________________________ in
{language} ______________________ which I understand.
Dated: ______________________ _____________________________________
Signature of Party
____________________________________
Signature of NONLAWYER
Printed Name: ________________________
Name of Business: _____________________
Address: _____________________________
_____________________________________
IN THE COUNTY COURT OF THE SIXTH JUDICIAL CIRCUIT
IN AND FOR PINELLAS COUNTY, FLORIDA
Reference No: ______________________
__________________________
Plaintiff(s)
vs.
___________________________
Defendant(s)
NOTICE OF VOLUNTARY DISMISSAL
Plaintiff(s), __________________________________, in the above styled cause hereby
submit this Notice of Voluntary Dismissal as this cause has been settled between parties.
I certify that a copy of this document was [¥ one only]
mailed faxed and mailed
hand delivered to the person(s) listed below on the _____ day of ______________, 20_____.
Defendant(s):________________________
Address:____________________________
City, State, Zip: ______________________
Dated: __________________
Signature of Plaintiff(s)
Print Name:
Address:
City, State, Zip:
Telephone No:
Form 15 3/2011 Residential Eviction for Non-Payment of Rent
FORM 12 Revised by Clerk 04/2021
Tenant’s name and address:
____________________________
____________________________
____________________________
____________________________
Dear ____________________________,
(Tenant’s Name)
This is a notice of my intention to impose a claim for damages in the amount of $__________________
(insert amount of damages)
upon your security deposit due to _________________________________________________________
____________________________________________________________________________________.
(insert damages do premises or other reason for claiming security deposit)
This notice is sent to you as required by §83.49(3), Florida Statutes. You are hereby notified that you
must object in writing to this deduction from your security deposit within 15 days from the time you
receive this notice or I will be authorized to deduct my claim from your security deposit. Your objection
must be sent to _______________________________________________________________________.
(insert landlord’s address)
Landlord’s name: ________________________
Address: _______________________________
City, State, Zip: __________________________
Telephone Number: ______________________
Approved for use under rule 10-2.1(a) of
the Rules Regulating The Florida Bar
The Florida Bar 2010
This form was completed with the assistance of:
Name: _________________________________
Address: _______________________________
City, State, Zip: __________________________
Telephone number: ______________________
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KEN BURKE, C.P.A. CLERK OF THE CIRCUIT COURT (Pinellas County Clerk of the Circuit Court and Comptroller)

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Completed 24 June 2021

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