COURT COUNTY OF ........................................................... : Petitioner (Landlord): -against: : Respondent (Tenant) : Address : Respondent (Under tenant) Address : : Residing at: Upon Tenant's Default Index No. NON-PAYMENT Judgment Rendered in Favor of Landlord : ........................................................... A notice of petition, containing a notice of demand for judgment for rent due, together with the petition, having been duly filed in the office of the clerk of this court, and it appearing that the same were served upon the respondent(s) herein by (insert and proof of said service duly filed within three days after said service, and the method of service) notice of petition having been made returnable before the within court on (date) at (time) and the respondent/tenant having failed to appear and answer at the time and place designated in the notice of petition; Now, on motion of attorney(s) for the petitioner/landlord herein, it is ADJUDGED, that the delivery of the possession of the property described in the petition be awarded to the petitioner/landlord with costs of this proceeding; and it is further ADJUDGED, that petitioner/landlord residing at recover of respondent(s)/tenant(s) residing at the sum of $ which is the amount of rent determined to be due the petitioner/landlord, together with interest thereon in the sum of $ together with $ costs and disbursements of this proceeding, amounting in all to the sum of $ and that the petitioner/landlord have execution therefore; and it is further ADJUDGED, that a warrant of eviction issue, such issuance to be stayed to and including the 20 Dated: Enter, day of Justice Judgment entered in accordance with the foregoing. Dated: Clerk American LegalNet, Inc. www.FormsWorkflow.com