Trial Court of Masschussetts
District Court Department
REQUEST FOR DEFAULT JUDGMENT
(Mass R. Civ P. 55(b)(3))
I, ________________________________________________________________, the undersigned, request that default
judgment be entered against the defendant(s) ____________________________________ in the amount of $_______________
1.
2. The defendant is not an infant or incompetent person.
3.
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Signature: ___________________________________________
Name: ______________________________________________
Attorney for: __________________________________________
Address: _____________________________________________
Telephone: ___________________________________________
The defendant is not in the military service of the United States or its Allies, as defined in the Servicemembers Civil
Relief Act as evidenced by the following facts:
together with interest in the sum of $_________________ with costs and affirm that:
The total amount due the plaintiff(s), exclusive of costs in his claim against the defendant, is $__________________.
REQUEST FOR
DEFAULT JUDGMENT
DEFENDANT'S NAME, ADDRESS, ZIP CODE AND PHONE
________________________________________________
________________________________________________
________________________________________________
PLAINTIFF'S NAME, ADDRESS, ZIP CODE AND PHONE
________________________________________________
________________________________________________
________________________________________________
___________________________
