Name of Person Filing: Your Address: Your City, State, Zip code: Your Telephone Number: ATLAS Number (if applicable): Representing Self (Without an Attorney) OR Attorney for Petitioner OR Respondent For Clerk’s Use Only SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY Case No. (Name of Petitioner) APPLICATION AND AFFIDAVIT FOR DEFAULT (IN FAMILY COURT CASES WITHOUT MINOR CHILDREN) (Name of Respondent) NOTICE: THIS IS AN IMPORTANT COURT DOCUMENT. When this document is properly completed and filed, Default has been applied for and entered. The Default will be effective ten (10) working days after the filing of this completed document, unless the Respondent files an Answer/Response or otherwise defends before the ten working day period expires. 1. 2. I am the Petitioner in this court case. I understand and make the following statements under oath or by affirmation. I give notice that I am requesting entry of default against the other party, the Respondent, because the Respondent has not filed an Answer/Response. Service of the court papers on Respondent has been accomplished as follows: (check ONLY one box) The Respondent has signed an “Acceptance of Service” and has accepted service of the “Summons,” Complaint or Petition and other papers. The Respondent has not filed an “Answer/Response”, or otherwise appeared or defended in this court case. Default may be entered. OR I have served the Respondent according to law with the “Summons,” Complaint or Petition and other papers. Respondent has not appeared, answered, responded or otherwise defended in the time required by law. 3. The Respondent is either not in the active military service of the United States or has otherwise waived his/her rights under the Service Members Civil Relief Act (formerly “Soldiers and Sailor’s Civil Relief Act”). 4. By completing the Certificate of Mailing (on the next page), I certify to the Court that I have mailed a copy of this Application and Affidavit to the Respondent, and if applicable, to his or her attorney, unless service was made by publication, and no current or former address is known, as notice that I have applied for default. ©Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED AAD Page 1 of 2 DRDA61f-033011 American LegalNet, Inc. www.FormsWorkFlow.com Case No. CERTIFICATE OF MAILING As required by Arizona Rules of Court (A.R.C.P. 55(a) and A.R.F.L.P. 44(A)). On (date) 20____, a copy of this Application and Affidavit for Default was mailed, postage-prepaid, to the Respondent at his/her: current address (as listed below), OR (if current address is unknown) his/her last known address, as listed below: (address, city, state) IF I know the Respondent, who I claim to be in default, is represented by an attorney, I have also mailed a copy of this Application and Affidavit to that attorney. OATH OR AFFIRMATION I swear or affirm the contents of this document are true and correct under penalty of perjury. Signature Date Affirmed before me this: by (Date) Printed Name of Person Who Signed My Commission Expires: or Seal (below) : Deputy Clerk or Notary Public WARNING 1. If the Respondent fails to file a responsive pleading or otherwise defend in this action within 10 working days after the filing of this Application, A DEFAULT JUDGMENT MAY BE ENTERED. 2. The Petitioner must still attend the default hearing at the court UNLESS you qualify, apply for and complete the process to obtain a default decree without a hearing. 3. A DEFAULT HEARING WILL NOT BE SCHEDULED IF THIS APPLICATION AND AFFIDAVIT FOR DEFAULT IS MISSING INFORMATION OR NOT COMPLETED CORRECTLY. ©Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED AAD Page 2 of 2 DRDA61f-033011 American LegalNet, Inc. www.FormsWorkFlow.com