(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 (secured claim) The plaintiff states the following claim(s): 1. The plaintiff(s) is the secured creditor of the defendant(s). 2. The defendant(s) is indebted to the plaintiff in the amount of $______ pursuant to an agreement dated _______________, _______. 3. Pursuant to the agreement described above, the plaintiff has a security interest in the following property: ______________________________________________________________________. 4. The plaintiff is lawfully entitled to foreclosure of the specific property described above. 5. The estimated value of each item of personal property is $______. 6. The defendant(s) is no longer entitled to possess the property by reason of default under the agreement identified above. WHEREFORE, the plaintiff(s) demands judgment against the defendant(s) for: 1. Judgment in the amount of: (a) Principal amount $______. (b) Attorneys fees $______. (c) Interest before judgment ______% per year from ____________________, ______. (d) Interest after judgment ______% per year. (e) and costs. American LegalNet, Inc. www.USCourtForms.com 2. Foreclosure of its security interest on the property _________________________________. 3. That the court enter its judgment and decree herein determining that the plaintiff’s security interest is a first and prior lien on said property and superior to all the claims, right, title and interest and liens of all other defendant(s), and that if the principal and interest due the plaintiff(s) is not paid within ten days of the judgment, that an order of sale be issued to the sheriff of this county commanding him to advertise and sell said property and apply the proceeds of the sale as follows: (a) To the payment of the costs of this action, including the costs of sale; (b) To the payment of all taxes found to be due on said property; (c) To the payment of the amount with interest found thereon to the plaintiff(s); (d) The balance, if any, to be paid to the clerk of the court to abide by further order of the court. 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