Commonwealth of MassachusettsS U F F O L K , S S . BOSTON MUNICIPAL COURT DEPARTMENTPlaintiff(s) Civil Action No. Defendant(s)APPLICATION PURSUANT TO MASS. R. CIV. P. 33(a) FORENTRY OF JUDGMENT FOR - AS APPROPRIATE.The says that on 20 , interrogatories were served upon the ,and the provisions of Mass. R. Civ. P. 33(a) have been complied with, and that the party interrogated has failed toserve timely answers or objections thereto within forty-five (45) days or such shorter or longer time as the courton motion with or without notice may specify, or the parties may stipulate, pursuant to Mass. R. Civ. P. 29.The says that on 20 , the Court ordered theto further answer interrogatories within days, and that the party interrogated has failed to serve suchfurther answers within said time.The says that on 20 , a final request for answers to interrogatories was servedupon the(and a copy of said request is accompanied herewith), and the provisions of Mass. R. Civ. P. 33(a) have beencomplied with, and that the party interrogated has failed to serve timely answers or objections thereto withinforty (40) days or such other period as was prescribed by order of the Court appearing on record, or within suchfurther time as the parties have agreed.Wherefore, the make(s) application that judgment be entered for in accordance with the provision of Rule33(a).Dated at Boston, Massachusetts, this day of , 20 .THIS STATEMENT IS MADE UNDER THE PENALTIES OF PERJURY. Signed Print or TypeAtty. for Plff - Deft. Print or TypeAddress Tel. No. BBO No. 9* A p p t o a n s . t o o r i g i n a l i n t s .9* A p p t o f u r . a n s .NOTES: A plaintiff filing this application whose claim is f or a sum certain or for a sum which can by computation be made certain should also file a Request for BMC-CV-009APPLICATION PER RULE 33(a)(Rev. 6/10 swf)Judgment for Relief per Rule 55(b)(1) (form BMC-CV-029). A plaintiff filing this application whose claim is not a sum certain or a sum which cannot by computationbe made certain should mark this matter for a hearing on the assessment of damages, with notice to the defendant.A defendant filing this application need not accompany it with any additional papers, unless a defendant222s execution is to be requested. American LegalNet, Inc. www.FormsWorkFlow.com