Form Aoc-216-Forcible Detainer Complaint Form
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1AOC-216
Doc. Code: PFD
Case No. ____________________
Rev. 1-15
Page 1 of 1
l e x
Court
____________________
e t
j u s t i t i a
Commonwealth of Kentucky
County
____________________
Court of Justice
FORCIBLE DETAINER
Division
____________________
COMPLAINT
KRS 383.200
Provide Name and Address for both Plaintiff (Landlord) and Defendant (Tenant)
LANDLORD/PLAINTIFF
Name:
Address:
VS.
TENANT/DEFENDANT
Name:
Address:
Comes the Plaintiff and for his/her complaint states that:
1.
On the _________ day of __________________, _______, Defendant(s) contracted to lease __________________
____________________________________________________________________________________________
located at ____________________________________________________________________________________
under a [ ] written OR [ ] oral lease with Plaintiff as lessor;
2.
Under the lease terms, Defendant(s) agreed to pay $___________ per [ ] day [ ] week [ ] month, payable on
the _____________ day of each [ ] week
[ ] month
[ ] year as rent;
3.
Defendant(s) has/have breached the lease by not paying rent for the [ ] day [ ] week [ ] month [ ] year of
____________________________________ in the amount(s) of $_______________ and has/have not paid late fee
for the [ ] day [ ] week [ ] month [ ] year of _______________________________________ in the amounts
of $_____________________.
4.
As of _________________________, _____ the total amount of back rent and late fee(s) owed to the Plaintiff from
date
the Defendant(s) is: ___________________.
5.
Defendant(s) has/have breached the lease because of the following: ___________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
6.
Plaintiff gave Defendant(s) written notice to vacate on __________________, _____. Defendant(s) has/have not vacated.
WHEREFORE, Plaintiff alleges Defendant(s) unlawfully and forcibly detain the premises, and demand(s) possession of
the premises be delivered to Plaintiff, as well as any and all other relief to which he/she may be entitled. I hereby certify
I am the owner/attorney of the above-named property.
________________________________________________
_____________________________________
Landlord/Attorney Signature
Phone Number
________________________________________________
______________________________________
Landlord/Attorney Name (Please Print)
Landlord/Attorney Address
Subscribed and sworn to before me this ______ day of ____________________ , 2_______. My commission expires:
____________________ , 2_______.
_____________________________________
Signature
__________________________________Title
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