L&T Form 5 SUPERIOR COURT OF THE DISTRICT OF COLUMBIA CIVIL DIVISION LANDLORD AND TENANT BRANCH Bldg. B, 510 4th Street, NW, RM. 110 Washington, DC 20001 Telephone (202) 879-4879 Plaintiff v. Defendant APPLICATION FOR TERMINATION OF STAY AND NOTICE TO DEFENDANT The Court will please note that the defendant has failed to comply with the consent judgment entered on (date) _________________________________ by: (1) Failing to make the payment(s) due on or before __________________________; and/or (2) Failing to (specify violation): ___________________________________________________________. For these reasons, the Court should terminate the stay of execution and immediately issue a writ of restitution. NOTICE OF HEARING The Clerk of the Court has scheduled this application for a hearing on (date) ______________________ at 9:30 a.m. in Courtroom B-53. I have confirmed this date with the Clerk of the Court. Notice to Tenant: if you wish to oppose this application, you must appear for the hearing. CERTIFICATE OF SERVICE (Check only one.) L&T On (date) a copy of this application was: hand-delivered to the defendant or their attorney. mailed to the defendant or the defendant's attorney at the following address: ______________________________. Certification or Oath* I hereby certify/swear that the foregoing information is true and correct to the best of my knowledge and belief and this application was mailed or delivered as provided in L&T Form 4. Signature of Plaintiff/Landlord, or Attorney Printed Name and Bar Number (if applicable) Phone Number Date Street Address City, State, Zip Subscribed and sworn before me this ______ day of ______________, ______ My Commission expires _____________. Notary Public _____________________________________ *This certificate, if signed by the plaintiff's attorney, need not be under oath. American LegalNet, Inc. www.FormsWorkFlow.com