) HAMILTON SUPERIOR COURT NO. 6 ) SS: COUNTY OF HAMILTON ) CAUSE NO. 29D06-________-SC-___________ ___________________________________, ___________________________________, Plaintiff(s), vs. ___________________________________, ___________________________________, Defendant(s). VERIFIED MOTION FOR DEFAULT JUDGMENT The Plaintiff requests the Court to enter a default judgment against the Defendant(s) as set forth below. The Plaintiff states that, to the best of his/her knowledge and belief: The Defendant(s) in this case was/were served with a copy of the Notice of Claim in this case and has/have failed to appear for trial or plead after receiving proper notice. I have no reason to believe that the Defendant(s) is/are either a minor or incompetent. For purposes of complying with the Soldiers and Sailors Civil Relief Act of 1940, 50 USC 520, I have no reason to believe that the Defendant(s) is/are in the active military service of the United States. The Defendant(s) owe(s) the Plaintiff(s) the following amounts: a. Damages/Principal b. Prejudgment Interest (if claimed) c. Attorney Fees (if claimed) d. Other ______________________ Total (excluding filing fees) Dated: ___________________, 20___. $______________ $______________ $______________ $______________ $______________ ____________________________________ Plaintiff or Plaintiff's Attorney DEFAULT JUDGMENT The Court, being duly advised, hereby: STATE OF INDIANA I affirm, under the penalties for perjury, that the foregoing representations are true. denies the motion for default judgment because __________________________________________. finds that the Plaintiff appeared and that the Defendant(s) failed to appear for first trial setting and grants the motion for default judgment. The Court orders the Clerk enter judgment in favor of the Plaintiff(s) and against the following Defendant(s) _______________________________________________________________ in the sum of $________________, plus court costs of $________ (total $_________________). Dated: ___________________, 20___. Distribution: ____ Plaintiff/Attorney ____ Defendant/Attorney _________________________________________________ Gail Bardach, Judge Hamilton Superior Court No. 6 Rev. 1/07 Mo for DF w O American LegalNet, Inc. www.FormsWorkFlow.com