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Application To Clerk For Entry Of Default - State Of Rhode Island And Providence Plantations District Court Page 3

STATE OF RHODE ISLAND AND

PROVIDENCE PLANTATIONS

DISTRICT COURT

AFFIDAVIT AS TO MILITARY SERVICE AND COMPETENCY

The undersigned, being duly sworn, upon information and belief deposes and say:

That the Defendant is not an infant or an incompetent, and presently resides at

__________________________________________________ in ________________________,

Rhode Island; and [PLEASE CHECK THE APPLICABLER BOX]

 That the Defendant was not at the commencement of the above-entitled action, nor is now, in

the “Military Service” of the United States as defined in the Servicemember’s Civil Relief Act,

50 App. U.S.C. § 521, nor is the Defendant an American citizen serving with the forces of a

United States ally or a reservist/draftee called to active duty; or

 That despite exercising due diligence, the Plaintiff lacks sufficient information and has been

unable to determine whether the Defendant is in “Military Service.”

________________________________

Signature of the Plaintiff

State of _______________________

County of _____________________

On this ________ day of ________________, 20____, before me, the undersigned notary

public, personally appeared ____________________________________  personally known to

the notary or  proved to the notary through satisfactory evidence of identification, which was

_____________________________________________, to be the person who signed the

preceding or attached document in my presence, and who swore or affirmed to the notary that the

contents of the document are truthful to the best of his or her knowledge.

Notary Public: ____________________________________

My commission expires: ________________________

Notary identification number: _______________

ENTRY OF DEFAULT

It appearing that the Defendant in the above-entitled case has failed to plead or otherwise

defend as provided by the Rhode Island District Court Rules of Civil Procedure, now therefore

DEFAULT is hereby entered for the Plaintiff and against the Defendant.

Date of Entry of Default

Clerk

/s/ __________________________________________

DC-36 (revised May 2016)

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Application To Clerk For Entry Of Default - State Of Rhode Island And Providence Plantations District Court Page 3