DEFAULT ACTION COVER SHEET - B (for use per SDCL 15-6-54(d) as amended 7-1-04) Anyone seeking a judgment on a collection must complete and sign this sheet. The sheet must accompany the pleading. 1. Is suit on file? _____ (must file) 2. Is affidavit of default prepared and filed? _____ (must prepare and file) 3. Is application/affidavit of disbursements prepared and filed with motion and affidavit of default? _____ (may file under amendment to SDCL 15-6-54(d)) 4. Was any partial payment made on the debt? _____ Has the partial payment been credited? _____ 5. Was collateral involved in the transaction? _____ collateral. __________ 6. Was the collateral repossessed? _____ Was the collateral sold? _____ What proceeds resulted from the sale of the collateral? __________ Have the proceeds been credited against the debt? _____ 7. Are you requesting pre-judgment interest? _____ Please state the amount and rate. Amount __________ rate _____ Please include Form #8 or its equivalent. 8. Is this an open account collection? _____ If yes, interest is limited to ten percent. (Category B, SDCL 54-3-16; Scotland, etc. v. ABA, etc., 583 N.W.2d 834 (SD 1998)). 9. Are you requesting attorney fees? _____ If so, please state the amount __________. Was an attorney used in the prosecution of this claim? _____ Please include form #1 or #8, and #4 or their equivalents. ONLY REGULATED LENDERS AS DEFINED BY SDCL 54-3-14 MAY COLLECT ATTORNEYS FEES. (SEE SDCL 15-17-39 AND SDCL 54-3-13.) Are you a regulated lender? _____ Please state type of lender or assignment.______________________________________________________________ _______________________________________________________________________. Please state the original value of 10. Are you requesting taxation of disbursements and expenses at this time? _____ If so, please state amounts and types. Service Fees Amount _____________________ Clerk’s Fees – Amount _____________________ Copying Costs – Amount _____________________ Please include form #8 or its equivalent. Dated ________________________ Plaintiff or attorney ____________________________ (2nd Circuit Default Judgment form #7, August, 2004)