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Affidavit Of Non Compliance Form. This is a Minnesota form and can be use in Hennepin Local County.
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Tags: Affidavit Of Non Compliance, Minnesota Local County, Hennepin
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
:
STATE OF MINNESOTA
Index No.
Calendar No.
FOURTH JUDICIAL DISTRICT
COUNTY OF HENNEPIN
Plaintiff(s)
-against-
:
JUDICIAL SUBPOENA
DISTRICT COURT
:
AFFIDAVIT OF NON-COMPLIANCE
:
___________________________________________
Plaintiff
vs
HOUSING COURT PREFILING MEDIATION
:
Defendant(s)
:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Case .No. __________________________
... .
___________________________________________
Defendant
THE PEOPLE OF THE STATE swear or affirm
I, __________________________,OF NEW YORK that on _____________, __________________________
print your name
date agreement signed
print other party’s name
TO
and I signed a Mediated Settlement Agreement (copy must be attached).
_________________________________________ has not complied with the agreement by failing to
print other party’s name
GREETINGS:
do the following:
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at the
Court
located at
County of
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
result of your failure to comply.
Date: _____________________
Witness, Honorable
Court in
County,
day of
________________________________________________
, one of the Justices of the
Signature
, 20
Subscribed and sworn to before
(Attorney must sign above and type name below)
me on ________________, 20___.
_________________________________
Court Clerk/Notary
Attorney(s) for
If the agreement is not kept, fill out this document and return with a copy of agreement, complaint or
affidavit of rent escrow and the appropriate filing fee to:
Office and P.O. Address
Hennepin County Housing Court
A-1700 Government Center
300 South 6th Street
Telephone No.:
Minneapolis, MN 55487
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
Affidavit of Non Compliance-Housing Court Pre-filing Mediation
Last Revised 2/9/02
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