Page 1 of 2 Revised February 2019 251 201 9 Coconino County Law Library Person Filing : Mailing Address: City, State, Zip: Phone Number: Representing Self COCONINO COU NTY SUPERIOR COURT Petitioner: Case Number: DO APPLICATION FOR DEFAULT AND ENTRY OF DEFAULT Respondent: Notice t o Respondent: If you do not file a written response with the court or otherwise defend in this action within 10 days of this Application being filed, a default judgment may be entered against you. I , Petitioner, ask the court to enter default of Responden t. I served a copy of the Petition and Summons on Respondent , and Respondent failed to plead or otherwise defend in this action within the time required by law. Respondent is not in military service. Certificate of Mailing : On the day I file it, I will mail a copy of this document to the other party and his/her attorney if he/she has one at but you do not know it now : Respondent: Street Address: City, State, Zip: Street Address: City, State, Zip: American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2 Revised February 2019 251 201 9 Coconino County Law Library Sign in front of a notary. Notaries are at the Self - Help Center in the Courthouse and at most banks or listed in the Yellow Pages. The person signing must bring photo ID. Notaries usually charge a fee. State of Arizona County of ) ) ) Subscribed and sworn before me this date : by: Seal: Notary Public: Notary Expiration Date: ENTRY OF DEFAULT Respondent was properly served with the necessary papers in this case. Respon dent failed to respond in the manner or time required by law. Default of Respondent is entered. Date: Clerk of Superior Court by Deputy Cler k American LegalNet, Inc. www.FormsWorkFlow.com