JUSTICE COURT , HENDERSON TOWNSHIP CLARK COUNTY, NEVADA Owners Name: Business Name/DBA: Agents Name: CASE NO. Address: DEPT NO. AFFIDAVIT OF COMPLAINT Plaintiff/Landlord, - vs - FOR SUMMARY EVICTION Name: NON-PAYMENT OF RENT Address: Defendant/Tenant. , being first duly sworn, (or) under penalty of perjury, deposes states: and 1. He/she is either the landlord or an agent foe landlord, at the premr th ises located within Henderson Township, County of Clark, State of Nevada, and situated at: 2. The tenancy commenced on . The amount of periodic rent is $ per . The tenant paid a rent deposit of $ a security deposit of and a cleaning deposit of . 3. Rental payment became delinquent on and the tenant has remained in possession without paying rent since that date. The amount of rent claimed due and delinquent is $ . 4. On the day of , 20 , a written Notice was served on the t enant in accordance with NRS 40.280, a copy of the Notice with the Proof of Service is attached to this Affidavit. 5. Affiant requests that the Court enter an Order for the Summary Eviction of the Tenant(s) from the premises and the Constable be ordered to removete tnahent(s) within twenty-four (24) hours after receipt of the Court Order. Signature Address Phone Number City/ State/ Zip Code DECLARATION UNDER PENALTY OF PERJURY PER NRS 53.045: I declare under penalty of perjury that the foregoing is true and correc t. Date S ignature JC Henderson Rev. 04/05