IN THE COU NTY COU RT IN AND FOR HIL L SBO ROU GH COU NTY, FL ORI DA CIVIL DIVISI ON *CA SE NO. *DIV IS ION Plaintiff(s) vs * * Defendant(s) AFFIDAV IT IN PROOF OF CL AIM AN D NON-MILIT ARY S ER VICE S T AT E OF F L ORI DA C OU NT Y OF HI L L S BOR OU GH Before me, the undersigned authority, personally appeared ,who duly swor n, deposes and says: 1. T hat he/she is the Landlord of rented premises located in Hillsbor ough County, Florida, described as follows: 2. T he Defendant(s), 3. The Defendant(s) was/were served a day notice on at AM /PM,demanding possession of said premises. 4. T he Defendant(s) failed to comply with the demands of the notice within the applicable time period. 5. T he D efendant(s) is/are not now nor has been in the military service of the United S tates of Am erica since theinstitution of this action. La ndlord S T AT E OF F L ORI DA C OU NT Y OF HIL L S BOR OU GH T he foregoing instrument was acknowledged before me this day of , , by who is personally known to me or who has produced as identification and who did [ ]did not [ ] take an oath. P A T FR A NK As Clerk of the Court As Deputy Clerk Notary Public Ty ped or Pr inted Name COCV1240(Rev.1/4/2005) American LegalNet, Inc. www.USCourtForms.com