Complaint For Eviction For Non-Payment Of Rent
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1STATE OF RHODE ISLAND AND
PROVIDENCE PLANTATIONS
DISTRICT COURT
COMPLAINT FOR EVICTION FOR NON-PAYMENT OF RENT
Civil Action File Number
Plaintiff/Landlord
Plaintiff/Landlord’s Attorney
Plaintiff/Landlord’s Attorney or Plaintiff/Landlord Address
Defendant/Tenant
Defendant/Tenant’s Address
2
Division District Court
3
Division District Court
nd
rd
Murray Judicial Complex
Noel Judicial Complex
45 Washington Square
222 Quaker Lane
Newport, Rhode Island 02840-2913
Warwick, Rhode Island 02886-0107
4
Division District Court
6
Division District Court
th
th
McGrath Judicial Complex
Garrahy Judicial Complex
4800 Tower Hill Road
One Dorrance Plaza
Wakefield, Rhode Island 02879-2239
Providence, Rhode Island 02903-2719
1. The Plaintiff/Landlord is the owner of the rental premises listed above, in which the Defendant/Tenant
currently resides.
2. The Defendant/Tenant is more than fifteen (15) days in arrears in rental payments due to the
Plaintiff/Landlord from the Defendant/Tenant. The rent is $_______________ per ___________________,
and the amount in arrears is $____________________________ as of the _________ day of
____________________, 20____.
3. The Plaintiff/Landlord has served the five-day demand notice as required by law, and a copy of that notice
is attached to this complaint. The notice was mailed to the Defendant/Tenant on the _________ day of
____________________, 20____.
4. The Defendant/Tenant has not paid the rent in arrears or offered the full amount in arrears either before or
after the demand notice. The Defendant/Tenant remains in possession of the rental premises.
WHEREFORE, the Plaintiff/Landlord requests that this court grant a judgment for possession of the
premise (eviction of the Defendant/Tenant) and for back rent in the amount of $_________________________,
together with a fair rental value for use and occupation from the present until entry of judgment plus costs.
_________________________________
By _____________________________________________
Date filed with clerk
Plaintiff/Landlord or Attorney
DC-28 (revised August 2012)
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