Residential Eviction Complaint Form - Circuit Court Of The State Of Oregon
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1IN THE CIRCUIT COURT OF THE STATE OF OREGON
FOR THE COUNTY OF POLK
Case No. ________________
RESIDENTIAL EVICTION COMPLAINT
PLAINTIFF (Landlord or Agent):
DEFENDANT (Tenants/Occupants):
___________________________________
___________________________________
___________________________________
___________________________________
Address: ___________________________
VS.
Address: ___________________________
City: _______________________________
City: _______________________________
State: ________ Zip: __________________
State: ________ Zip: __________________
Telephone: ________________________
Telephone: ________________________
_
Defendant’s Social Security number ________________________ (Optional information for
purposes of identification.
1. Tenants are in possession of the dwelling unit, premises or rental property described above or
located at:
_____________________________________________________________________________
Street Address
City
State
Zip
2. Landlord is entitled to possession of the property because of:
24-hour notice for personal injury, substantial damage, extremely outrageous act or unlawful
occupant. ORS 90.396 or 90.403.
24-hour or 48-hour notice for violation of drug or alcohol program. ORS 90.398.
24-hour notice for perpetrating domestic violence, sexual assault, or stalking. ORS 90.445.
72-hour or 144-hour notice for nonpayment of rent. ORS 90.394.
7-day notice with stated cause in a week-to-week tenancy. ORS 90.392(6).
10-day notice for a pet violation, a repeat violation in a month-to-month tenancy or without
stated cause in a week-to-week tenancy. ORS 90.405, 90.427(1), or 90.392(5).
20-day notice for a repeat violation. ORS 90.630(4).
30-day or 180-day notice without stated cause in a month-to-month tenancy. ORS 90.427(2)
or 90.429.
30-day notice with stated cause. ORS 90.630, 90.632, or 90.392.
Other notice _______________________________________________________________
No notice (explain) __________________________________________________________
A COPY OF THE NOTICE RELIED UPON, IF ANY, IS ATTACHED
3. If the landlord uses an attorney, the case goes to trial and the landlord wins in court, the landlord
can collect attorney fees from the defendant pursuant to ORS 90.255 and 105.137(3). Landlord
requests judgment for possession of the premises, court costs, disbursements and attorney fees.
I certify that the allegations in this complaint are true to the best of my knowledge.
____________
___________________________________________
Date
Signature of Plaintiff or Agent
Certified to be a true and correct copy of the original on file.
Trial Court Administrator
Date: ____________
(SEAL)
By
____________________________________________________
Judicial Services Specialist
Revised 01/2008;PLK04/08
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