STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS SUPERIOR COURT JUDGMENT BY DEFAULT UPON APPLICATION TO CLERK Plaintiff Civil Action File Number Defendant Murray Judicial Complex Newport County 45 Washington Square Newport, Rhode Island 02840-2913 McGrath Judicial Complex Washington County 4800 Tower Hill Road Wakefield, Rhode Island 02879-2239 Noel Judicial Complex Kent County 222 Quaker Lane Warwick, Rhode Island 02886-0107 Licht Judicial Complex Providence/Bristol County 250 Benefit Street Providence, Rhode Island 02903-2719 In this action, the Defendant, ________________________________, having been regularly served with the summons and complaint, and having failed to plead or otherwise defend, the legal time for pleading or otherwise defending having expired and the default of the Defendant, ________________________________, in the premises having been duly entered according to law; upon the application of the Plaintiff, judgment is hereby entered against the Defendant, ________________________________, in pursuance of the prayer of said complaint. Wherefore, by virtue of the law and by reason of the premises aforesaid, It is ordered, that the Plaintiff does have and recover from the Defendant, ________________________________, the sum of ____________________________ dollars with interest thereon from the date hereof, till paid, together with the Plaintiff's cost. This Judgment By Default Upon Application To Clerk was entered on /s/ _________________________________________ Clerk _____________________________. Superior-52 (revised June 2015) American LegalNet, Inc. www.FormsWorkFlow.com