1 Case No.: __________________ Dept.: __________ 2 IN THE JUSTICE COURT OF PAHRUMP TOWNSHIP 3 COUNTY OF NYE, STATE OF NEVADA 4 5 _______________________________________ Plaintiff/Landlord, 6 7 8 vs. AFFIDAVIT OF LANDLORD _______________________________________ Defendant/Tenant. 9 10 11 12 13 14 STATE OF NEVADA ss. COUNTY OF NYE The undersigned Plaintiff/Landlord, being first duly sworn, deposes and says: 1. jurisdictional confines of Pahrump Township, Nye County, Nevada. 15 16 17 18 That your Affiant is the Landlord of certain dwellings or apartments within the 2. That your Affiant rented a certain dwelling or apartment to: ______________________________________________________________________ (Defendant/Tenant) located at ______________________________________________________________ (Address) 19 20 21 22 on the _____________ day of _____________________, 20____, with periodic rental payments reserved by month, or for a shorter time period, of $__________________. a. the sum of $____________________. 23 24 25 Cleaning or rental deposit paid in advance in excess of the first month’s rent in b. Date rental payment delinquent ________________________. c. Length of time without paying rent ___________________________. d. Date rent due _______________________. -1- 12/08/08 American LegalNet, Inc. www.FormsWorkFlow.com 1 2 e. 3. 3 4 Amount of rent due $__________________________. That the periodic rental payments have not been waived or altered by a written agreement of any kind. 4. That the above-named Tenant is in arrears on rent and that the proper notice(s) 5 has/have been served on the Tenant in accordance with the provision of Nevada 6 Revised Statutes, Chapter 40, as amended. 7 5. A copy of the Affidavit of Service is attached hereto and made a part of this Affidavit. 8 6. A copy of the Notice of Eviction is attached hereto and incorporated herein. 9 7. That the parties did not execute a written rental agreement. A copy of the written rental agreement is attached. 10 11 did 8. That more than five (5) judicial days have elapsed since the service of the Notice of 12 Eviction as indicated on the Affidavit of Service, but the above-named Tenant has 13 refused and still refuses to vacate and quit the above-mentioned premises. 14 WHEREFORE, your Affiant prays for an Order of this Court, directed to the Sheriff of Nye 15 County, ordering the above-named Tenant from the above-mentioned premises, as provided for in 16 NRS, Chapter 40. DATED: _________________________, 20_____. 17 18 _________________________________________ Landlord / Petitioner 19 20 21 SUBSCRIBED and SWORN to before me this ______ day of __________________, 20___. 22 23 24 ________________________________________ NOTARY PUBLIC 12/08/08 25 -2- American LegalNet, Inc. www.FormsWorkFlow.com