Form Cv 8150-120.02 - Application For Entry Of Default - Maricopa County Justice Courts, Arizona Page 5

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Maricopa County Justice Courts, Arizona
Please select court from the drop down list -----------------------
CASE NUMBER:
Plaintiff(s) Name / Address / Email / Phone
Defendant(s) Name / Address / Email / Phone
Attorney for Plaintiff(s) Name / Address / Email / Phone
Attorney for Defendant(s) Name / Address / Email / Phone
REQUEST and AFFIDAVIT FOR ENTRY OF DEFAULT JUDGMENT
With Hearing
Without Hearing
JCRCP Rule 140
I request that the Court enter a default judgment.
If I am the Plaintiff, then I state that the Summons, Complaint and the Notice to Defendant were served on the Defendant.
No response has been received within the time allowed by law. At least ten (10) judicial days have passed since the Entry
of Default.
The Defendant
is
is not on active duty in the United States Military.
Principal $
Costs $
Attorney fees $
Interest $
Total $
Attached are the:
Proposed Judgment
Supporting documents / proof of debt
Statement of cost
I state under penalty of perjury that the forgoing is true and correct.
Date:
Signature
Plaintiff
Counterclaimant
3rd Party Plaintiff
Attorney
Note: A party who files a proposed default judgment must also provide the court with stamped envelopes
addressed to each party.
I CERTIFY that a copy of this document has been or will be mailed on
to:
Plaintiff at the above address
Plaintiff's attorney
Defendant at the above address
Defendant's attorney
Date:
By
Signature
CV 8150-120.03 R: 4/13/17

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