Commonwealth of Kentucky Court of Justice www.courts.ky.gov KRS 383.200 U RT OF JUS TI C E AOC-216 Rev. 1-15 Page 1 of 1 Doc. Code: PFD COM M O NW E A LT H O F K E lex et justitia Case No. ____________________ Court County Division ____________________ ____________________ ____________________ NT U C KY FORCIBLE DETAINER COMPLAINT Provide Name and Address for both Plaintiff (Landlord) and Defendant (Tenant) Name: Address: VS. Name: Address: Comes the Plaintiff and for his/her complaint states that: 1. On the _________ day of __________________, _______, Defendant(s) contracted to lease __________________ ____________________________________________________________________________________________ located at ____________________________________________________________________________________ under a [ ] written OR [ ] oral lease with Plaintiff as lessor; 2. 3. Under the lease terms, Defendant(s) agreed to pay $___________ per [ ] day [ ] week [ ] month, payable on the _____________ day of each [ ] week [ ] month [ ] year as rent; Defendant(s) has/have breached the lease by not paying rent for the [ ] day [ ] week [ ] month [ ] year of ____________________________________ in the amount(s) of $_______________ and has/have not paid late fee for the [ ] day [ ] week [ ] month [ ] year of _______________________________________ in the amounts of $_____________________. CO LANDLORD/PLAINTIFF TENANT/DEFENDANT 4. 5. As of _________________________, _____ the total amount of back rent and late fee(s) owed to the Plaintiff from the Defendant(s) is: ___________________. Defendant(s) has/have breached the lease because of the following: ___________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ date 6. Plaintiff gave Defendant(s) written notice to vacate on __________________, _____. Defendant(s) has/have not vacated. WHEREFORE, Plaintiff alleges Defendant(s) unlawfully and forcibly detain the premises, and demand(s) possession of the premises be delivered to Plaintiff, as well as any and all other relief to which he/she may be entitled. I hereby certify I am the owner/attorney of the above-named property. ________________________________________________ Landlord/Attorney Signature _____________________________________ Phone Number ________________________________________________ Landlord/Attorney Name (Please Print) ______________________________________ Landlord/Attorney Address Subscribed and sworn to before me this ______ day of ____________________ , 2_______. My commission expires: ____________________ , 2_______. _____________________________________ Signature __________________________________Title American LegalNet, Inc. www.FormsWorkFlow.com