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(Form 61 A) IN THE COUNTY COURT, IN AND FOR DUVAL COUNTY. FLORIDA CASE NO: DIVISION: (Insert name of Landlord) Plaintiff(s) VS. (Insert name of Tenant) Defendant(s) COMPLAINT FOR EVICTION AND DAMAGES Plaintiff, and alleges: , sues Defendant, COUNT 1 Tenant Eviction , 1. This is an action to evict a tenant from real property In Duval County, Florida. 2. Plaintiff owns the following described real property in said County: (insert street description of rental property including unit number) 3. Defendant has possession of the property under (circle one) oral/written agreement to pay payable rent of $ (insert rental amount) (insert terms of rental payments, i. c., weekly, monthly, etc.) A copy of the written agreement, if applicable, is attached hereto as Exhibit ''A.'' 4. Defendant failed to pay the rent due (insert date of' payment tenant has failed to make) American LegalNet, Inc. www.FormsWorkFlow.com 5. Plaintiff served Defendant with a notice on (insert date of notice) to pay the rent deliver possession, but Defendant refuses to do either. A copy of the notice is attached as Exhibit "B.'' WHEREFORE, Plaintiff demands judgment for possession of the property against Defendant. COUNT II Damages 6. This is an action for damages that do not exceed $15,000. 7. Plaintiff restates those allegations contained in paragraphs 1 through 5 above. 8. Defendant owes Plaintiff $ since that is due with interest (insert past due rent amount) (insert date of lost rental payment tenant failed to make) 9. Additionally, the plaintiff sues for additional unpaid rent that accrues after the file date of this complaint as well as damages that become evident upon inspection of the property and after the defendant is evicted. WHEREFORE. Plaintiff demands judgment for damages against Defendant. Signature Name of Landlord/Property Manager (Circle one) Address City, State, Zip Code Phone Number Approved for use under rule 10-1. 1 (b) of the Rules Regulating The Florida Bar American LegalNet, Inc. www.FormsWorkFlow.com