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KEN BURKE, C.P.A.
CLERK OF THE CIRCUIT COURT AND COMPTROLLER
PINELLAS COUNTY, FLORIDA
www.mypinellasclerk.org
11/2016
EJECTMENT
FILING FEE: $400.00
SUMMONS ISSUANCE FEE: $10.00 per summons
COPIES REQUIRED: Originals to the Clerk.
1 set of copies for service.
1 set of copies for your records.
ADDITIONAL COSTS: $3.50 per Acknowledgement
(If you do not have your signature
notarized in the required spaces
before filing, the Deputy Clerk
can do this for you. Please DO NOT
SIGN until a Notary or Deputy
Clerk instructs you to do so.)
SERVICE FEE: You must contact a private process
(You must provide a pre-addressed server, or persons allowed to do
stamped envelope to mail all of service in the county where service is
your issued summons and/or to be done, to obtain their service fees.
copies for service. If a sufficient You can get a list of local process
envelope and postage is not servers from the sheriff by accessing a
provided, your summons will not link through our website at
be returned or mailed.) www.MyPinellasClerk.org
.
11/2016
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 Centers is to assisW citizens representing
themselves in court (sometimes referred to as pro se persons) who do NOT have a private attorney.
&itizens who represent themselves in court and do not already have a private attorney representing them, can
now get affordable legal assistance.
OUR SERVICES INCLUDE:
x 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.)
x Purchase forms and packets for WKHcivil court actions OLVWHVDERYH
x Have documents notarized
x Make copies
Open Monday through Friday from 8:30 a.m. until 4:30 p.m.:
x
The Clearwater Self Help Center
3 &RXUW6WUHHW,5RRP
Clearwater, FL 33756
Phone: (727) 464-5150
Fax: (727) 453-3423
o Appointments may be scheduled for
Thursday and/or Friday.
o A Spanish interpreter provided by the
Hispanic Outreach Center is availableE\
DSSRLQWPHQWat theClearwater location
on Fridays from 10:00a.m. until 12:00 p.m.
x
The St. Petersburg Self Help
Center
The St. Petersburg Judicial Building
545 First Avenue North5RRP
St Petersburg, FL 33701
Phone: (727) 582-7941
Fax: (727) 582-7945
o Appointments may be scheduled for
Monday WednesdayDQGRU)ULGD\
x The North County Branch Self Help Center
29582 U.S. 19 North5RRP
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 E\FUHGLWFDUGFDVK check or money
order. Refunds will not be issued for missed appointments.
Ken Burke, CPA
Clerk of the Circuit Court
& Comptroller
Pinellas County, Florida
MAILING CHARGES GUIDELINES
The chart below can be used as a reference when determining the type of envelope and the
amount of postage it will cost to mail your summons back.
If the proper size envelope and sufficient postage is not provided, your summons will not be
returned or mailed.
ENVELOPE SIZE
#10 OR 6X9
WEIGHT
NUMBER OF
PAGES
COSTS
1 oz 1-6 .49
2 oz 7-11 .70
3 oz 12-17 .91
3.5 oz 18-25 1.12
ENVELOPE SIZE
FLAT OR 9X12
WEIGHT
NUMBER OF
PAGES
COSTS
1 oz 1-6 .98
2 oz 7-12 1.19
3 oz 13-18 1.40
4 oz 19-23 1.61
5 oz 24-29 1.82
6 oz 30-37 2.03
7 oz 38-42 2.24
8 oz 43-48 2.45
9 oz 49-54 2.66
10 oz 55-59 2.87
11 oz 60-67 3.08
12 oz 68-73 3.29
13 oz 74-79 3.50
Rates are subject to change. You may visit the United States Posta
Services at www.usps.com for up to date pricing.
Paper weight will vary causing the price of the number of pages per
ounce to change.
COMPLAINT FOR EJECTMENT
When should this form be used?
x Ejectment is used to remove a person or persons who occupy your real
property, and incorrectly claim title to that property.
x The property must be located within Pinellas County.
x The individual(s) occupying the property are not tenants.
x The action is filed in Circuit Court. See ejectment forms for more details.
Example – You legally purchase a piece of property from the owner and record
the deed. The former owner then sells the same property again to someone else.
The other person is residing on the property and claims that they own it because
they bought it from the former owner.
If your situation does not meet these criteria, ejectment may not be the appropriate
action, and you should review the information on eviction and unlawful detainer.
CONTACT AN ATTORNEY with any questions. This does not constitute legal advice.
Ejectment is a circuit court lawsuit filed pursuant to Florida Statute Chapter 66, to
request that another person leave your property when they incorrectly claim title to that
property.
READ ALL OF THE INFORMATION AND INSTRUCTIONS BEFORE
COMPLETING THE FORMS AND SUBMITTING THEM FOR FILING.
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 OWN RECORDS.
DOCUMENTS MUST BE LEGIBLE, TYPE WRITTEN OR LEGIBLY
HANDWRITTEN IN BLACK OR BLUE INK.
Filing fee: $400.00
Summons issuance fee: $10.00 per summons
Payable by cash/personal check/cashiers check/certified check/money order/ credit
card (MasterCard, Visa, American Express or Discover)
IN ADDITION to the above mentioned filing fee and summons issuance fee, a fee is
required to serve each defendant. You must obtain a private process server to serve the
summons. A list of process servers is available through the Pinellas Sheriff’s website at
http://www.pcsoweb.com or from any Pinellas Clerk of Court office or Self-Help Center.
Revised 10/2016 Ejectment Packet
It is important to remember that a delay can occur as a result of any errors on your
paperwork, or if the proper fees are not submitted.
FILING CHECKLIST
Step One (File case with Clerk)
To file an Ejectment case, you may file the following forms along with the filing fee
and any service fees, if applicable, with the Clerk’s office.
k Complaint for Ejectment
(1) Original filed with the Clerk and (1) copy for each Defendant to be served
k Civil Cover Sheet
k Affidavit of Military Status
k Summons
(1) Original and (1) copy for each Defendant to be served
Step Two (Obtain Judgment)
5 days after service on the Defendant(s) and the Defendant(s):
DID NOT respond, you may file the following forms:
k Motion for Clerk’s Default
k Motion for Default Judgment
k Final Judgment
(1) Original and (1) copy for each Plaintiff AND Defendant and pre-
addressed stamped envelope for each party as well
OR
DID respond, you may file the following forms:
k Notice of Hearing
(It is your responsibility to contact the Judicial Assistant for the Judge
that is assigned to your case, to set a hearing date. Once you have set your
hearing, complete this form and make copies. File the original, and submit
a copy to the Defendant(s).) k Final Judgment
(Bring the Final Judgment and (1) copy for each Plaintiff AND
Defendant to the hearing and (1) pre-addressed stamped envelope for
each party as well
If the judge grants your complaint, a Final Judgment will be signed.
Revised 7/2010 Ejectment Packet
Step Three (Obtain Writ of Possession)
If the Defendant(s) refuses 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.
Additional Forms
k Disclosure from Nonlawyer, if applicable
This form is for your records and should only be used if a nonlawyer assists you
in completing any forms. The nonlawyer must complete this form and both of
you are to sign it before the nonlawyer assists you in completing any forms.
k Notice of Voluntary Dismissal
If you decide not to proceed with your case prior to a judgment being entered,
you should file a Notice of Voluntary Dismissal.
THIS DOES NOT CONSTITUTE LEGAL ADVICE. Civil court
information and forms provided by the Pinellas County Clerk of Circuit
Court should be considered informational only, and may not be
applicable to 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.
4XLFN5HIHUHQFH*XLGH
7R&RPSOHWLQJ)RUPV3ULRU7R)LOLQJ
&RPSODLQWIRU(MHFWPHQWIURP5HDO(VWDWH)RUP
¾ Fill in parties’ 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).
¾ Read each line and fill in the appropriate response.
¾ Date and sign in the space provided and print or type your name, address and telephone
number.
¾ Attach a chain of title to the complaint. A FKDLQRIWLWOH is a record of successive
conveyances, or other forms of alienation, affecting a particular parcel of land, arranged
consecutively, from the government or original source of title down to the present
holder.
"Chain of Title." Black’s Law Dictionary
. 6th ed. 1990.
&LYLO&RYHU6KHHW)RUP
¾ Fill in names of Plaintiff(s) and Defendant(s).
¾ Select “Other Real Property Actions” under Real Property/Mortgage Foreclosure for the
appropriate money amount.
¾ Check the appropriate box to indicate whether a jury is being demanded in the
complaint.
¾ Date and sign the cover sheet.
1RQPLOLWDU\$IILGDYLW)RUP
¾ Fill in names of Plaintiff(s) and Defendant(s).
¾ Read each line and select and/or fill in the appropriate response.
¾ 'DWHDQGVLJQLQWKHSUHVHQFHRID1RWDU\3XEOLFRU'HSXW\&OHUN
6XPPRQV3HUVRQDO6HUYLFHRQDQ,QGLYLGXDO)RUP
¾ Fill in names of Plaintiff(s) and Defendant(s).
¾ Provide the name and address of the party being served (Defendant).
¾ Provide the name and address of the serving party (Plaintiff).
¾ Once completed the &OHUN will date and sign for issuance.
0RWLRQIRU&OHUN¶V'HIDXOW)RUP
¾ Fill in names of Plaintiff(s) and Defendant(s).
¾ Fill in the name of the party a default will be entered against (Defendant).
¾ Sign in the space provided and print or type your name, address and telephone number.
¾ Once completed the &OHUN will date, sign and seal for issuance.
1RWLFHRI+HDULQJ)RUP
¾ Fill in names of Plaintiff(s) and Defendant(s).
¾ Read each line and fill in the appropriate response with the hearing information obtained
from the judge’s assistant.
¾ Provide the name and address of the party being served, select the type of service used
and the date it was perfected.
¾ Sign in the space provided and print or type your name, address and telephone number.
Revised 7/2010 Ejectment Packet
Revised 7/2010 Ejectment Packet
0RWLRQIRU'HIDXOW)LQDO-XGJPHQW)RUP
¾ Fill in names of Plaintiff(s) and Defendant(s).
¾ Fill in the name of the party you are requesting a default against (Defendant).
¾ Fill in the date of the default entered by the Clerk, if available.
¾ Sign in the space provided and print or type your name, address and telephone number.
)LQDO-XGJPHQWIRU(MHFWPHQW)RUP
¾ Fill in names of Plaintiff(s) and Defendant(s).
¾ Read each line and fill in the appropriate response.
¾ Fill in the name and addresses of all parties that will receive a copy.
¾ Once completed, the -XGJH will sign and date this form.
:ULWRI3RVVHVVLRQ)RUP
¾ Fill in names of Plaintiff(s) and Defendant(s).
¾ Complete the property description
¾ Fill in the name of the party receiving possession (Plaintiff).
¾ Once completed the &OHUN will date, sign and seal for issuance.
'LVFORVXUHIURP1RQODZ\HU)RUP
¾ Read each line and select and/or fill in the appropriate response.
¾ Both persons should sign in the space provided
1RWLFHRI9ROXQWDU\'LVPLVVDO)RUP
¾ Fill in names of Plaintiff(s) and Defendant(s).
¾ Fill in the name of the person dismissing the action (Plaintiff).
¾ Provide the name and address of the party being served, select the type of service used
and the date it was perfected.
¾ Sign in the space provided and print or type your name, address and telephone number.
Ejectment Packet Form #1
,17+(&,5&8,7&28572)7+(6,;7+-8',&,$/&,5&8,7
,1$1')253,1(//$6&2817<)/25,'$
Reference No: ______________________ UCN: 5220___ CA____________XXCICI
__________________________
Plaintiff(s)
vs.
___________________________
Defendant(s)
&203/$,17)25(-(&70(17)5205($/(67$7(
COMES NOW, the Plaintiff(s), ______________________________________, sues
Defendant(s), ___________________________________________ and states as follows:
1. This is an action to recover possession of real property located in Pinellas County, Florida.
2. The Defendant(s) is in possession of the following real property in the County:
________________________________________________________________________
(Describe property, i.e. address or legal description)
to which Plaintiff(s) claims title as shown by the attached statement of Plaintiff’s chain of title.
3. Defendant(s) refuses to deliver possession of the property to Plaintiff(s) or pay Plaintiff(s) the
profits from it.
1RWH$VWDWHPHQWRI3ODLQWLII¶VFKDLQRIWLWOHPXVWEHDWWDFKHG
:+(5()25(Plaintiff(s) demands judgment for possession of the property and damages
against Defendant(s).
Date: __________________
Signature of Plaintiff(s)
Print Name:
Address:
City, State, Zip:
Telephone No:
(Form 1.997 Civil Rules of Procedure 1/2010)
CIRCUIT COURT, PINELLAS COUNTY, FLORIDA
CIVIL DIVISION
CIVIL COVER SHEET
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
Case #:
Judge:
vs.
Defendant
II. 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
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
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
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
(Form 1.997 Civil Rules of Procedure 1/2010)
Ejectment Packet Form #3
IN THE CIRCUIT COURT OF THE SIXTH JUDICIAL CIRCUIT
IN AND FOR PINELLAS COUNTY, FLORIDA
Reference No: ______________________
__________________________
Plaintiff(s)
vs.
___________________________
Defendant(s)
NONMILITARY AFFIDAVIT
I, ^IXOOOHJDOQDPH`BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB being sworn, certify that
the following information is true:
[¥ all that apply]
_____ 1. I know of my own personal knowledge that Defendant(s) is not on active duty in the
armed services of the United States.
_____ 2. I have inquired of the armed services of the United States and the U.S. Public Health
Service to determine whether the Defendant(s) is a member of the armed services and am
attaching certificates stating that Defendant(s) is not now in the armed services.
I understand that I am swearing or affirming under oath to the truthfulness of the
claims made in this affidavit and that the punishment for knowingly making a false
statement includes fines and/or imprisonment.
Date: __________________
Signature of Plaintiff(s)
Print Name:
Address:
City, State, Zip:
Telephone No:
STATE OF FLORIDA
COUNTY OF ___________________
Sworn to or affirmed and signed before me on ______________by__________________________.
__________________________________
NOTARY PUBLIC or DEPUTY CLERK
____________________________________
[Print, type, or stamp commissioned name of notary or clerk.]
_____ Personally known
_____ Produced identification
Type of identification produced ______________________
Page 1 of 2 Ejectment Packet Form #4
,17+(&,5&8,7&28572)7+(6,;7+-8',&,$/&,5&8,7
,1$1')253,1(//$6&2817<)/25,'$
Reference No: ______________________
__________________________
Plaintiff(s)
vs.
___________________________
Defendant(s)
6800216
3(5621$/6(59,&(21$1$785$/3(5621
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
action on:
Defendant:_________________________
Address ___________________________
City, State, Zip______________________
,03257$17
Each defendant is UHTXLUHG to serve written defenses to the complaint on:
Plaintiff:___________________________
Address ___________________________
City, State, Zip______________________
within 20 days after service of this summons on that defendant, exclusive of the day of service,
DQG to file the original of the defenses with the Clerk of this Court at 315 Court Street, Room
170, Clearwater, Florida 33756, either before service on plaintiff or immediately thereafter. If a
defendant fails to do so, a default will be entered against that defendant for the relief demanded
in the complaint.
DATED:
.(1%85.(&3$
Clerk of the Circuit Court
ȱȱ315 Court Street, Room 170
Clearwater, FL 33756
(Seal)
BY: ______________________________
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 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”
named below.
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.
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).
IMPORTANT
Des poursuites judiciares ont ete entreprises contre vous. Vous avez 20 jours consecutifs a partir
de la date de l.assignation de cette citation pour deposer une reponse ecrite a la plainte ci-jointe 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 egalement, 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.
Plaintiff/Plaintiff.s Attorney
................................................
................................................
Address
Florida Bar No. ......................
Page 2 of 2 Ejectment Packet Form #4
Ejectment Packet Form #5
,17+(&,5&8,7&28572)7+(6,;7+-8',&,$/&,5&8,7
,1$1')253,1(//$6&2817<)/25,'$
Reference No: ______________________
__________________________
Plaintiff(s)
vs.
___________________________
Defendant(s)
027,21)25&/(5.¶6'()$8/7
Plaintiff(s) asks the clerk to enter a default against ______________________________,
Defendant(s), for failing to respond as required by law to Plaintiff’s Complaint for Ejectment
from Real Estate.
Signature of Plaintiff(s)
Print Name:
Address:
City, State, Zip:
Telephone No:
'()$8/7
A default is entered in this action against the Defendant(s) for ejectment for failure to
respond as required by law.
DATED:
.(1%85.(&3$
Clerk of the Circuit Court
ȱȱ315 Court Street, Room 170
Clearwater, FL 33756
BY: ____________________________
DEPUTY CLERK
Ejectment Packet Form #6
,17+(&,5&8,7&28572)7+(6,;7+-8',&,$/&,5&8,7
,1$1')253,1(//$6&2817<)/25,'$
Reference No: ______________________
___________________________
Plaintiff(s)
vs.
___________________________
Defendant(s)
027,21)25'()$8/7),1$/-8'*0(17(-(&70(17
Plaintiff(s) asks the court to enter a Default Final Judgment against _________________,
Defendant(s), for ejectment, and says:
1. Plaintiff(s) filed a Complaint for Ejectment from Real Estate against
Defendant(s).
2. Defendant(s) has failed to timely file an answer and a Default has been entered by
the Clerk of this Court on the ________ day of _________________, 20_______.
WHEREFORE, Plaintiff(s) asks this Court to enter a Final Judgment for Ejectment
against the Defendant(s).
Date: __________________
Signature of Plaintiff(s)
Print Name:
Address:
City, State, Zip:
Telephone No:
IN THE CIRCUIT COURT OF THE SIXTH JUDICIAL CIRCUIT
IN AND FOR PINELLAS COUNTY, FLORIDA
Reference No: ______________________
___________________________
Plaintiff(s)
vs.
___________________________
Defendant(s)
NOTICE OF HEARING
TO: Defendant(s): ____________________________________________________________
There will be a hearing before Judge BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB
on ^GDWH` ____________________ at ^WLPH`BBBBBBBBBBBBBBBBBBB, in Room ______________
of the Pinellas County Courthouse located at
on the following issues:
______________________________________________________________________________
______________________________________________________________________________
___________hour(s)/___________ minutes have been reserved for this hearing.
If this matter is resolved, the moving party shall contact the judge’s office to cancel this
hearing.
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: _________________________
Address: ___________________________
City, State, Zip:______________________
Dated: __________________
Signature of Plaintiff(s)
Print Name:
Address:
City, State, Zip:
Telephone No:
Ejectment Packet Form #7
“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.”
Ejectment Packet Form #8
,17+(&,5&8,7&28572)7+(6,;7+-8',&,$/&,5&8,7
,1$1')253,1(//$6&2817<)/25,'$
Reference No: ______________________ UCN: 5220 CA XXCICI
__________________________
Plaintiff(s)
vs.
___________________________
Defendant(s)
),1$/-8'*0(17)25(-(&70(17
This cause having come before the Court on Complaint for Ejectment and it appearing
that the Defendant(s) has been duly served with process, it is hereby:
25'(5('$1'$'-8'*('that the Plaintiff(s), ____________________________,
do have and recover from the Defendant(s), __________________________________________,
possession of the following premises located in Pinellas County, Florida, to wit:
______________________________________________________________________________
(Describe property, i.e. legal description)
The Clerk of Court shall issue the Writ of Possession for the aforesaid premises forthwith.
It is further 25'(5('$1'$'-8'*(' that Plaintiff(s), _____________________,
recover judgment against the Defendant(s), _________________________________________ ,
costs in the amount of $________________, for all of which let execution issue.
'21($1'25'(5(' in Pinellas County, Florida on the _______ day of
______________, 20_______.
________________________________
CIRCUIT COURT JUDGE
cc:
Plaintiff _________________________
Address _________________________
City, State, Zip____________________
Defendant _______________________
Address _________________________
City, State, Zip____________________
Ejectment Packet Form #9
IN THE CIRCUIT COURT OF THE SIXTH JUDICIAL CIRCUIT
IN AND FOR PINELLAS COUNTY, FLORIDA
Reference No: ______________________
__________________________
Plaintiff(s)
vs.
___________________________
Defendant(s)
WRIT OF POSSESSION
THE STATE OF FLORIDA:
TO ALL AND SINGULAR THE SHERIFFS OF THE STATE:
YOU ARE COMMANDED to remove Defendant(s) _______________________,
from the following property in Pinellas County, Florida:
________________________________________________________________________
(Describe property, i.e. address or legal description)
and to put Plaintiff(s), _________________________________, in full possession thereof.
Witness my hand and seal of the Court on ______ day of ___________, 20_____.
KEN BURKE, CPA
Clerk of the Circuit Court
ȱȱ 315 Court Street, Room 170
Clearwater, FL 33756
(Seal)
BY: __________________________
DEPUTY CLERK
Plaintiff __________________________
Address __________________________
City, State, Zip_____________________
Phone #___________________________
Ejectment Packet Form #10
121/$:<(56:+2$66,6727+(56,1&203/(7,1*)2506
If a nonlawyer will help you in completing forms in this booklet, that person must
provide you a copy of the disclosure on the bottom of this page before beginning. Both you and
the nonlawyer helping you must sign the disclosure form. You should receive a copy to keep and
the nonlawyer helping you should keep a copy. This disclaimer does not act as or constitute a
waiver, disclaimer, or limitation of liability.
Anyone assisting you in completing these forms also must put their name, address, and
telephone number on the bottom of the last page of the form. A space is provided on each form
for this purpose.
',6&/2685(
________________________________ told me that he/she is not a lawyer and may not give
legal advice or represent me in court.
________________________________ told me that he/she may only help me fill out a form
approved by the Supreme Court of Florida. ________________________________may only
help me by asking me questions to fill in the form. ________________________________may
also tell me how to file the form. _________________________________ told me that he/she is
not an attorney and cannot tell me what my rights or remedies are or how to testify in court.
>¥ RQO\one@
BBB I can read English.
___ I cannot read English, but this disclosure was read to me [fill in ERWK blanks] by
{Name}________________________ in {Language} ____________________,
which I understand.
______________________________
Signature
______________________________
Signature
Ejectment Packet Form #11
,17+(&,5&8,7&28572)7+(6,;7+-8',&,$/&,5&8,7
,1$1')253,1(//$6&2817<)/25,'$
Reference No: ______________________
__________________________
Plaintiff(s)
vs.
___________________________
Defendant(s)
127,&(2)92/817$5<',60,66$/
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 [¥ RQHonly]
mailed faxed and mailed
hand delivered to the person(s) listed below on the ____ day of ______________, 20______.
Defendant:_________________________
Address:___________________________
City, State, Zip: _____________________
Dated: __________________
Signature of Plaintiff(s)
Print Name:
Address:
City, State, Zip:
Telephone No:
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KEN BURKE, C.P.A. www.mypinellasclerk.org (Pinellas County Clerk of the Circuit Court and Comptroller)

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Completed 10 February 2021

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