(Revised 7/05) File Stamp Date Case Number ______ Prepared by: Filer’s name, SC# Filer’s address Filer’s phone number {Filer’s fax phone number} {Filer’s e-mail address} Attorney for Plaintiff In The District Court of ______ County, Kansas Plaintiff’s name Plaintiff vs. Defendant’s name Defendant’s address Case No. ______ Defendant Pursuant to Chapter 61 of Kansas Statutes Annotated PETITION (eviction & rent) The plaintiff states the following claim(s): 1. The plaintiff is the owner of or the agent of the owner of the following described premises: ______________________________________________________________________________ . 2. The defendant(s) is in possession of the premises pursuant to a rental agreement dated ___________________, _______. 3. The defendant(s) has failed to pay rent due under the agreement described above and is indebted to the plaintiff for rent in the amount of $______. 4. The plaintiff gave the defendant(s) a notice to leave the premises described above dated ___________________, ______ as required by law. WHEREFORE, the plaintiff demands judgment against the defendant(s) for: rent amount interest before judgment interest after judgment for costs, $______, ______% per year from ______, ______% per year, and for judgment against the defendant(s) and all other occupants for: American LegalNet, Inc. www.USCourtForms.com restitution and possession of the premises, and writ of restitution. _________________________________ Plaintiff or Plaintiff Attorney Signature SC# {If applicable, include the following: This is a communication from a debt collector. This is an attempt to collect a debt and any information obtained will be used for that purpose.} American LegalNet, Inc. www.USCourtForms.com