400-00806 – Motion for Default Judgment (03/2018) Page 1 of 1
Plaintiff Date Of Birth Defendant Date Of Birth
MOTION FOR DEFAULT JUDGMENT
Under oath, I, _____________________________, state that the facts are true on information and belief:
Print Name
1. I filed this action with the Court on .
Date of Filing
2. Defendant was served with the summons, complaint and all other paperwork related to the filing
of this case on _______________________. An acceptance of service or a return of service has
Date of Service
been filed with the Court.
3. Defendant has not filed an answer and it has been at least 21 days since the date on which s/he
was served.
4. Defendant is not in the military service.
5. Defendant is not a minor (under 18 years of age).
6. Defendant is not incompetent.
I hereby swear or affirm that the information above is true to the best of my knowledge and belief.
Dated
_____________________________ ___________________________________
Signature Plaintiff
Signed and sworn to or affirmed before me:
Date Signature of Notary Public Expiration Date
