AFFIDAVIT TO REMOVE TENANT

Docket_________ Page________ STATE OF MISSISSIPPI HINDS COUNTY Plaintiff’s Name________________________________________________________________ Address_______________________________________________________________________ City & Zip Code:_______________________________________________________________ Telephone Number:________________________

Before me, the undersigned Justice Court Clerk in Hinds County, Mississippi, Landlord 

__________________________________________________, makes oath to the best of his/her 

knowledge and belief that Defendant, ______________________________________________ 

whose telephone number is _________________ , refuses to deliver possession of the following 

described property, to wit_________________________________________________________ 

______________________________________________________________________________ in said County and State; that there is now due from said Defendant the sum of $_____________ rent and the necessary notice according to law has been given to terminate such tenancy, and that satisfaction of said rent cannot be obtained by distress of the goods, ware and chattels of the said tenant. The affiant demands: 

COUNT ONE That the said_____________________________________________ be removed from the premises. COUNT TWO That a money judgement for the rent now due in the amount of $_____________ plus the rent to become due to the date of removal judgement, be rendered against the said tenants plus all cost in this cause to accrue. Rent amount to become due: $______

__________________________________ Plaintiff

Sworn to and subscribed before me, this the _______ day of ______________________, _____.

_________________________________ Justice Court Clerk