CCT504 State ENG Rev 7/15www.mncourts.gov/formsPage 1 of 2State of Minnesota Conciliation Court County of:Select County Court File Number: Judicial District: Case Type: ConciliationAffidavit and Order Vacating Order For Judgment and Granting New Trial Minn. R. Gen Pract. 520 (a) Plaintiff (first, middle, last)vs. Defendant (first, middle, last) , says that he/she is the Plaintiff Defendant in the above entitled action, that the case was called on for hearing and that he/she did not appear for the following reasons: That Plaintiff Defendantbelieves this is a just cause or defense and Plaintiff Defendantrequests the court to vacate the conciliation order and judgment entered on and to grant a new trial pursuant to Conciliation Court Rule 520(a). I declare under penalty of perjury that everything that I have stated in this document is true and correct. Minn. Stat. 247 358.116. Dated: Signature County and State where signed Name: Address: City/State/Zip: Telephone: E-mail address: American LegalNet, Inc. www.FormsWorkFlow.com CCT504 State ENG Rev 7/15www.mncourts.gov/formsPage 2 of 2State of Minnesota District Court County Select County Court File Number: Judicial District: Case Type: ConciliationORDER Plaintiffvs. DefendantBased upon the foregoing affidavit, and upon payment of the sum of $ as absolute conditional costs IT IS HEREBY ORDERED that said judgment be vacated and a new trial granted and that all parties be notified. This order becomes effective upon the payment of costs as ordered herein. If said fees are not paid by (date), the original judgment stands as entered. JudgeBY THE COURT: Dated:Notice of Trial Certificate of MailingCosts having been paid as provided in the order dated this matter isrescheduled for trial on , at at the (date) (time) (address of courthouse, city, state, and zip code)A copy of the Affidavit and Order Vacating Judgment and Granting New Trial and this Notice of Trial was mailed to (name and address of party)and the parties on this date. (name and address of party)Court Administrator's Office Dated:By: Deputy American LegalNet, Inc. www.FormsWorkFlow.com