Complaint Form Hawaii

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Plaintiff(s)
Reserved for Court Use
Civil No.
Defendant(s)
Plaintiff(s)/Plaintiff(s)’ Attorney (Name, Attorney Number,
Firm Name (if applicable), Address, Telephone and Facsimile
Numbers)
Premises Address:
COMPLAINT
l. This Court has jurisdiction over this matter and venue is proper.
2. Plaintiff(s) is the landlord or the agent for the landlord of the property.
3. The premises is located in this division of this Court.
4. Defendant(s) rents and/or is in possession of the property and/or is a personal guarantor under the rental agreement of the property.
There is a written rental agreement for the property. A copy of the written rental agreement for the premises
5.
(and any amendments to the rental agreement) is attached.
There is no written rental agreement for the property, only an oral agreement.
There is an expired written rental agreement for the property. A copy of the written rental agreement
(and any amendments to the rental agreement) is attached.
Defendant(s) is/are month-to-month tenant(s).
6. Defendant(s) has broken the rental agreement because:
Unpaid rent
$
Other
7. Written notice was given to Defendant(s) on (date)
,
20
to correct this situation
as follows:
5-day non-payment
10-day non-monetary default
45-day termination of month-to-month tenancy or
as specified in the rental agreement or statute(s). A copy of the written notice is attached.
8. Despite the notice, Defendant(s) has failed to correct this situation and still is in possession of the premises.
I certify that this is a full, true, and correct
copy of the original on file in this office.
Clerk, District Court of the above Circuit, State of Hawai‘i
Reprographics (05/11)
Page 1 of 2
COMPASP
2D-P-221
RevaComm 508 Certified

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