SUPERIOR COURT CIVIL DIVISION
_______________________ UNIT DOCKET NO. ___________________
______________________________________,
Plaintiff,
v.
______________________________________,
Defendant(s).
CER
TIFICATION IN SUPPORT OF COMPLIANCE WITH THE CARES ACT
Pursuant to Administrative Order 49, ¶ 22, all plaintiffs who file eviction actions for nonpayment of rent on or after
March 27, 2020, must file a certification in substantially this form, certifying either that they have complied with the
CARES Act’s restrictions or that the CARES Act requirements do not apply. If an eviction was filed without this
certification, plaintiffs must file it by August 14, 2020.
In c
ompliance with the federal Coronavirus Aid, Relief and Economic Security Act (CARES Act),
I, ______________________________________
[Plaintiff] [authorized representative or agent of Plaintiff] hereby
swear or affirm under penalty of perjury. (You must check one box.):
Plaintiff has complied with the requirements of the CARES Act. In particular, the action to evict
defendant(s) from the property was commenced on or after July 25, 2020, the landlord provided the tenant
with actual notice of the date of termination of tenancy, which was at least 30 days after the date of the
actual notice as required by § 4024(c) of the CARES Act, 15 U.S.C. § 9058(c).
OR
The property is not covered by the CARES Act. In particular, the dwelling from which the plaintiff seeks
to evict defendant(s) is not located on or in a “covered property,” which is defined in the CARES Act,
§ 4024, 15 U.S.C. § 9058(a)(2), as a property subject to those federal loans or participating in those federal
programs listed below. In order to make this certification, you must take the steps listed below, and check
both boxes.
I or my authorized agent has researched every unsatisfied mortgage on the property, and none of
them is a Fannie Mae, Freddie Mac, Federal Housing Administration, HUD, Dept. of Veterans
Affairs, USDA, or other federally backed mortgage. In doing this research, I have conducted
searches of all unsatisfied mortgages using the mortgage lookup tools of both Fannie Mae
(KnowYourOptions.com/loanlookup) and Freddie Mac (FreddieMac.com/mymortgage). I have
attached the first page of the unsatisfied mortgage(s) on the property as well as the results of my
searches of the above databases.
Neither the property nor any tenant of the property participates in or receives subsidies or benefits
under any federal housing program, including, but not limited to, Section 8 vouchers, housing
funded by the Department of Agriculture under §§ 514, 515, 516, 533, 538, or 542, Low-Income
Housing Tax Credit (LIHTC), or any McKinney Vento Act Homelessness Program.
Date: ____________________
Signature of Plaintiff or authorized agent or representative: ____________________________________________
Printed Name: ____________________________________________
Appendix A
Revised 8.19.2020
