COMMONWEALTH OF MASSACHUSETTS __________________, SS: HOUSING COURT DEPARTMENT _______________________ DIVISION / / / SP-_ / / / / / _____________________________________ Plaintiff/Landlord VS. ______________________________________ Defendant/Tenant NON MILITARY AFFIDAVIT AND AFFIDAVIT OF PAYMENTS MADE 1. The defendant(s) in the above captione d case is/are not believed in the military service as defined in the Servicemembers Civil Relief Act, and that I know this to be true because: _________________________________________________ ________________________________________________________________________ ______ ______________________________________________________________________________ 2. The defendant(s) has/have PAID rent (or use and occupation) in the amount of $ _____________________ since the action was commenced. 3. The defendant(s) still OWE rent (or use and occupation) in the amount of $ _________________ through _______________________________________________. 4. The defendant(s) still occupy/occupies th e premises described in my Complaint or, if the premises are no longer occupi ed, the defendant(s) vacated the premises on _____________________________________________________________________. Subscribed and sworn under the pains an d penalties of perjury, this ____________ day of ____________________, 200____. _____________________________________________ Signature of Plaintiff or Plaintiffs Attorney American LegalNet, Inc. www.USCourtForms.com