Affidavit Of Damages {Form 19}

Approved for use under rule 10-2.1(a) of the Rules Regulating The Florida Bar The Florida Bar 2010Form 19IN THE COUNTY COURT OF THE EIGHTH JUDICIAL CIRCUIT IN AND FOR ALACHUA COUNTY, FLORIDA , [Insert name of Landlord] Plaintiff, vs. , [Insert name of Tenant] Defendant. / CASE NO.: [insert case number assigned AFFIDAVIT OF DAMAGES STATE OF FLORIDA ) COUNTY OF ) BEFORE ME, the undersigned authority, personally appeared [name], who being first duly sworn, states as follows: 1.I am the Plaintiff or the Plaintiff222s agent (check appropriate response) in thiscase and am authorized to make this affidavit. 2.This affidavit is based on my own personal knowledge. 3.Defendant has possession of the property which is the subject of this eviction underan agreement to pay rent of $ [rental amount] per [week, month, or other payment period]. 4.Defendant has not paid the rent due since [date ofpayment tenant failed to make]. 5.Defendant owes Plaintiff $ [past due rent amount] as alleged inthe complaint plus interest. 6.Defendant owes Plaintiff $ [amount of other damages] asalleged in the complaint plus interest. Signature American LegalNet, Inc. www.FormsWorkFlow.com Approved for use under rule 10-2.1(a) of the Rules Regulating The Florida Bar The Florida Bar 2010Form 19Sworn and subscribed before me on [date], by [name], who is personally know to me/ produced [document] as identification, and who took an oath. NOTARY PUBLIC 226 STATE OF FLORIDA Name: Commission No.: My Commission Expires: I CERTIFY that I mailed, faxed and mailed, or hand delivered a copy of this motion and attached affidavit to the Defendant at [insert address at which tenant was served and fax number if sent by fax]. Name Address () Phone Number This form was completed with the assistance of: Name: Address: Telephone No.: () American LegalNet, Inc. www.FormsWorkFlow.com