IN THE JUSTICE COURT OF __________________________ TOWNSHIP IN AND FOR THE COUNTY OF _________________, STATE OF NEVADA Name: Address: Phone: ______________________ ______________________ ______________________ ______________________ Landlord/Plaintiff vs. Name: Address: Phone: CASE NO: ________________ _____________________ _____________________ _____________________ _____________________ Tenant/Defendant DEPT. NO:________________ AFFIDAVIT/DECLARATION IN SUPPORT OF MOTION TO CONTEST PERSONAL PROPERTY LIEN AND FOR RETURN OF PERSONAL PROPERTY I, ___________________________________ (Name), state that 1. I rented the property at____________________________ (Address) _____________________________________ (City and State) and lived there until____________________, 20____. 2. To the best of my knowledge the landlord and/or owner of the property is as stated above in the caption to this matter. Apartment 1 of Tenant Affidavit/Declaration in Support of Motion to Contest Personal Property Lien and for Return of Personal Property Form #21 5 ©2006 Nevada Supreme Court Revised: April 14, 2006 American LegalNet, Inc. www.FormsWorkflow.com _____ 3. I further state that _____ A. I abandoned the residence on the above date. _____ B. I was evicted by Order of the Justice Court. The date of the Order evicting me was ______________, 20____. _____ C. I left because I received a notice of eviction. _____ D. Other: (Explain) ___________________________________ ________________________________________________ ________________________________________________ ________________________________________________. _____ 4. My landlord still has some of my personal property. The general description of the property still in my landlord’s possession is as follows:_____________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ __________________________________________________________. _____ 5. I attempted to remove my property as follows: (State all attempts you made to remove your property and describe what happened for each attempt and dates.)____________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________. Apartment 2 of Tenant Affidavit/Declaration in Support of Motion to Contest Personal Property Lien and for Return of Personal Property Form #21 5 ©2006 Nevada Supreme Court Revised: April 14, 2006 American LegalNet, Inc. www.FormsWorkflow.com _____ 6. The date my landlord told me that I could not have my property until I paid him was ___________________, 20____. _____ 7. My landlord refused to allow me to take my property because: ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ __________________________________. _____ 8. The amount my landlord demanded was $________________. _____ 9. I disagree with: _____ A. The landlord’s right to hold my property. Explain your reasons for disagreeing:_____________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________. _____ B. The amount charged by me landlord. Explain your reasons for disagreeing and the specific dates you requested or were informed of any charges: ____________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________. WHEREFORE, I ask the Court to order the return of my personal property. Apartment 3 of Tenant Affidavit/Declaration in Support of Motion to Contest Personal Property Lien and for Return of Personal Property Form #21 5 ©2006 Nevada Supreme Court Revised: April 14, 2006 American LegalNet, Inc. www.FormsWorkflow.com I swear the above is true. Signature:__________________________________ SUBSCRIBED AND SWORN to before me this ____ day of _________________, 20____. NOTARY PUBLIC OR DEPUTY CLERK _____________________________ OR THE FOLLOWING: Pursuant to NRS 53.045: "I declare under penalty of perjury under the law of the State of Nevada that the foregoing is true and correct." Executed on _____________, 20____ ______________________________ Signature ______________________________ Print Name Apartment 4 of Tenant Affidavit/Declaration in Support of Motion to Contest Personal Property Lien and for Return of Personal Property Form #21 5 ©2006 Nevada Supreme Court Revised: April 14, 2006 American LegalNet, Inc. www.FormsWorkflow.com CERTIFICATE OF SERVICE Pursuant to NRCP 5(b) and JCRCP 5(b), I hereby certify that I am a nonparty over the age of 18 years, and that on ____________________________, 20____, I served a true and correct copy of the foregoing __________________________________________________________________, (Name of document that was served) addressed to: _______________________________________ _______________________________________ _______________________________________ _______________________________________ [ ] BY U.S. MAIL: I deposited for mailing in the United States mail, with postage fully prepaid, an envelope containing the above-identified document at _______________________________ (City and State), in the ordinary course of business. [ ] BY FACSIMILE TO: _______________________________ (FAX number). [ ] BY PERSONAL SERVICE: I personally hand delivered the above-identified document to the address/offices of the person named above. _______________________________ Signature of Server _______________________________ Print Name of Server Apartment 5 of Tenant Affidavit/Declaration in Support of Motion to Contest Personal Property Lien and for Return of Personal Property Form #21 5 ©2006 Nevada Supreme Court Revised: April 14, 2006 American LegalNet, Inc. www.FormsWorkflow.com