Circuit Court for City or County Case No. vs. Name Name Address Address City, State, Zip City, State, Zip Telephone Telephone Plaintiff REQUEST FOR ORDER OF DEFAULT I, Your Name Defendant , representing myself, request an Order of Default for failure to file a responsive pleading to: Opposing Party Indicate the name of the petition, complaint or motion you originally filed. against as provided by the Maryland Rules. The last known address of the opposing party is: Date Signature NON-MILITARY AFFIDAVIT : Opposing Party 1. is not in the military service of the United States; 2. is not in the military service of any nation allied with the United States; 3. has not been ordered to report for induction under the Selective Training and Service Act; and 4. is not a member of the Enlisted Reserve Corps who has been ordered to report for military service. 5. The following facts support the above statements: I solemnly affirm under the penalties of perjury that the contents of the foregoing paper are true to the best of my knowledge, information, and belief. Date Signature CC-DR-054 (Rev. 02/2017) American LegalNet, Inc. www.FormsWorkFlow.com