Prepared by: Filer's name, SC# Filer's address Filer's phone number {Filer's fax phone number} {Filer's e-mail address} Attorney for Plaintiff
(Revised 7/05) File Stamp Date Case Number ______
In The District Court of ______ County, Kansas Plaintiff's name vs. Defendant's name Defendant's address Pursuant to Chapter 61 of Kansas Statutes Annotated PETITION (eviction & rent) The plaintiff states the following claim(s): 1. The plaintiff is the owner of or the agent of the owner of the following described premises: Defendant Plaintiff Case No. ______
2. The defendant(s) is in possession of the premises pursuant to a rental agreement dated ___________________, _______. 3. The defendant(s) has failed to pay rent due under the agreement described above and is indebted to the plaintiff for rent in the amount of $______. 4. The plaintiff gave the defendant(s) a notice to leave the premises described above dated ___________________, ______ as required by law. WHEREFORE, the plaintiff demands judgment against the defendant(s) for: rent amount $______, interest before judgment ______% per year from ______, interest after judgment ______% per year, for costs, and for judgment against the defendant(s) and all other occupants for: restitution and possession of the premises, and writ of restitution. _________________________________ Plaintiff or Plaintiff Attorney Signature SC#
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{If applicable, include the following: This is a communication from a debt collector. This is an attempt to collect a debt and any information obtained will be used for that purpose.}