__________________________________ CIVIL CASE NUMBER ) ) COUNTY OF ________________________ ) ) _____________________________________ ) PLAINTIFF(S) ) ) VS. ) ) _____________________________________ ) DEFENDANT(S) ) STATE OF SOUTH CAROLINA IN THE MAGISTRATE'S COURT AFFIDAVIT OF DEFAULT Plaintiff, _______________________________, personally appearing before me, who being duly sworn, states that a summons and complaint in this action were served on the defendant, _____________________________________, on ______________________________ which required that defendant answer or appear within thirty (30) days from the date of service; that defendant failed to appear or answer as required and is now in default. Sworn to before me this day of ) ) ) ) ) ) ) ,2 Magistrate or Notary Public for South Carolina My Commission expires Plaintiff/Defendant (or his attorney) SCCA/717 (Amended 05/2008) American LegalNet, Inc. www.FormsWorkflow.com