Complaint In Summary Ejectment Form. This is a North Carolina form and can be use in Small Claims Statewide.
Tags: Complaint In Summary Ejectment, CVM-201, North Carolina Statewide, Small Claims
File No. STATE OF NORTH CAROLINA County COMPLAINT IN SUMMARY EJECTMENT G.S. 7A-216, 7A-232; Ch. 42, Art. 3 and 7 In The General Court Of Justice District Court Division-Small Claims 1. The defendant is a resident of the county named above. 2. The defendant entered into possession of premises described below as a lessee of plaintiff. Description Of Premises (Include Location) Conventional Public Housing Section 8 Type Of Lease Name And Address Of Plaintiff Month Date Rent Due Rate Of Rent $ per 3. County Week Oral Written The defendant failed to pay the rent due on the above date and the plaintiff made demand for the rent and waited the 10-day grace period before filing the complaint. The lease period ended on the above date and the defendant is holding over after the end of the lease period. Telephone No. The defendant breached the condition of the lease described below for which re-entry is specified. VERSUS Name And Address Of Defendant 1 Date Lease Ended Individual Corporation Criminal activity or other activity has occurred in violation of G.S. 42-63 as specified below. Description Of Breach/Criminal Activity (give names, dates, places and illegal activity) County Name And Address Of Defendant 2 4. The plaintiff has demanded possession of the premises from the defendant, who has refused to surrender it, and the plaintiff is entitled to immediate possession. Telephone No. Individual 5. The defendant owes the plaintiff the following: Corporation Description Of Any Property Damage Amount Of Damage (If Known) County Telephone No. Amount Of Rent Past Due $ $ Total Amount Due $ 0.00 6. I demand to be put in possession of the premises and to recover the total amount listed above and daily rental until entry of judgment plus interest and reimbursement for court costs. Date Signature Of Plaintiff/Attorney/Agent Name And Address Of Plaintiff's Attorney Or Agent CERTIFICATION WHEN COMPLAINT SIGNED BY AGENT OF PLAINTIFF I certify that I am an agent of the plaintiff and have actual knowledge of the facts alleged in this Complaint. Date AOC-CVM-201, Rev. 2/06 © 2006 Administrative Office of the Courts Signature (Over) American LegalNet, Inc. www.USCourtForms.com INSTRUCTIONS TO PLAINTIFF OR DEFENDANT 1. The PLAINTIFF must file a small claim action in the county where at least one of the defendants resides. 2. The PLAINTIFF cannot sue in small claims court for more than $5,000.00 excluding interest and costs. 3. The PLAINTIFF must show the complete name and address of the defendant to ensure service on the defendant. If there are two defendants and they reside at different addresses, the plaintiff must include both addresses. The plaintiff must determine if the defendant is a corporation and sue in the complete corporate name. If the business is not a corporation, the plaintiff must determine the owner's name and sue the owner. The PLAINTIFF may serve the defendant(s) by mailing a copy of the 4. summons and complaint by registered or certified mail, return receipt requested, addressed to the party to be served or by paying the costs to have the sheriff serve the summons and complaint. If certified or registered mail is used, the plaintiff must prepare and file a sworn statement with the Clerk of Superior Court proving service by certified mail and must attach to that statement the postal receipt showing that the letter was accepted. 6. The PLAINTIFF must pay advance court costs at the time of filing this Complaint. In the event that judgment is rendered in favor of the plaintiff, court costs may be charged against the defendant. 7. The PLAINTIFF must appear before the magistrate to prove his/her claim. 8. The DEFENDANT may file a written answer, making defense to the claim, in the office of the Clerk of Superior Court. This answer should be accompanied by a copy for the plaintiff and be filed no later than the time set for trial. The filing of the answer DOES NOT relieve the defendant of the need to appear before the magistrate to assert the defendant's defense. 9. The PLAINTIFF or the DEFENDANT may appeal the magistrate's decision in this case. To appeal, notice must be given in open court when the judgment is entered, or notice may be given in writing to the Clerk of Superior Court within ten (10) days after the judgment is entered. If notice is given in writing, the appealing party must also serve written notice of appeal on all other parties. The appealing party must PAY to the Clerk of Superior Court the costs of court for appeal within twenty (20) days after the judgment is entered. In filling out number 3 in the complaint, if the landlord is seeking to remove the tenant for failure to pay rent when there is no written lease, the first block 5. should be checked. (Defendant failed to pay the rent due on the above date If the defendant appeals and wishes to remain on the premises the and the plaintiff made demand for the rent and waited the ten (10) day grace 10. defendant must also post a stay of execution bond within ten (10) days period before filing the complaint.) If the landlord is seeking to remove the after the judgment is entered. tenant for failure to pay rent when there is a written lease with an automatic forfeiture clause, the third block should be checked. (The defendant 11. This form is supplied in order to expedite the handling of small claims. breached the condition of the lease described below for which re-entry is It is designed to cover the most common claims. specified.) And "failure to pay rent" should be placed in the space for description of the breach. If the landlord is seeking to evict tenant for violating some other condition in the lease, the third block should also be checked. If the landlord is claiming that the term of the lease has ended and 12. The Clerk or magistrate cannot advise you about your the tenant refuses to leave, the second block should be checked. If the case or assist you in completing this form. If you have landlord is claiming that criminal activity occurred, the fourth block should be checked and the conduct must be described in space provided. any questions, you should consult an attorney. AOC-CVM-201, Side Two, Rev. 2/06 © 2006 Administrative Office of the Courts American LegalNet, Inc. www.USCourtForms.com