JUSTICE COURT, LAS VEGAS TOWNSHIP Clark County, Nevada Case No. Department No. SMALL CLAIMS MOTION TO PLACE ON CALENDAR Name and Address of Plaintiff(s) VERSUS Name and Address of Defendant(s) COMES NOW, the Plaintiff Defendant Other: undersigned and hereby requests that the above entitled matter be placed on the Court222s calendar for hearing based on the following reasons (describe what action you want the Court to take and why): C E R T I F I C A T I O N O F M A I L ING The Undersigned certifies on the day of , 20 , a copy of the foregoing Motion to Place on Calendar was mailed to at by depositing a copy in the United States Mail in an addressed sealed envelope, postage prepaid. DATE: NAME: Per NRS 53.045, "I declare under penalty of perjury under the law of the State of Nevada that the foregoing is true and correct." (Signature): (Type or Print Name): (Date): LVJCVL Form -42, Revised 1/17 American LegalNet, Inc. www.FormsWorkFlow.com