Justice Court, Las Vegas Township CLARK COUNTY, NEVADA Owner’ s Name: CASE NO. Business Name/DBA: AFFIDAVIT OF COMPLAINT Agent’ s Name: FOR SUMMARY EVICTION Address: Plaintiff, ---vs--Name: Address: Defendant, , being duly sworn, (or) under penalty of perjury, states: 1. He/She is the (landlord) (the landlord’ duly appointed agent), at the premises located at s situated within Las Vegas Township, Clark County, Nevada. 2. The tenancy commenced on per . The amount of periodic rent is $ . The tenant paid a rent deposit of $ cleaning deposit of $ , a security deposit of $ and a . 3. Rental payments became delinquent on , and the tenant has remained in possession without payment of rent since that date. The amount of rent claimed due and delinquent is $ . 4. On the day of , , a written Notice to the tenant was served on the tenant in accordance with NRS 40.280, a copy of the Notice with the Proof of Service is attached to this Affidavit. 5. The tenant (did) (did not) sign a rental agreement. 6. Affiant requests that the Court enter an Order for the Summary Eviction of the Tenant from the premises and the Constable be ordered to remove the tenant within twenty-four (24) hours after receipt of the Court Order. SUBSCRIBED AND SWORN to before me this day of , AFFIANT Phone Number: NOTARY PUBLIC Street City, State, Zip OR: ONE OF THE FOLLOWING: Per NRS 53.045 (a) If executed in this state (Nevada): “ declare under penalty of perjury that the foregoing is true and correct.” I Executed on (Date) (Signature) (b) If executed outside of this state (Nevada): “ declare under penalty of perjury under the law of the State of Nevada that the foregoing is true and correct.” I Executed on (Date) (Signature) JC-13 (Civil) 11/99 American LegalNet, Inc. www.USCourtForms.com