Free IN THE JUSTICE COURT OF _TOWNSHIP - Nevada

IN THE JUSTICE COURT OF LAS VEGAS TOWNSHIP IN AND FOR THE COUNTY OF CLARK, STATE OF NEVADA Name: Address: Phone: ______________________ ______________________ ______________________ ______________________ Landlord/Plaintiff CASE NO: ________________ _____________________ _____________________ _____________________ _____________________ Tenant/Defendant DEPT. NO:________________

vs. Name: Address: Phone:

TENANT'S AFFIDAVIT/DECLARATION (Other than Nonpayment of Rent - Private Housing) The undersigned tenant states that: 1. I am a tenant of a certain rental unit within Las Vegas Township, Clark County, Nevada. 2. I rented the above unit from the above named landlord on or about ________________, 20____, with rent due monthly or for a shorter period of time. _____ 3. On the ________ day of ________________, 20___ I received a: _____ A. 30-day No-Cause Termination Notice to Vacate ­ NRS 40.251(1)(b). _____ B. 7-day No-Cause Termination Notice to Vacate ­ NRS 40.251(1)(a) _____ C.
Apartment Tenant Affidavit/Declaration (Other than Nonpayment of Rent, Private Housing) Form #16 Revised: April 14, 2006

5-day Notice of Termination for Violation of Lease or Rental 1 of 6 ©

Agreement ­ NRS 40.2516. _____ D. 3-day Notice of Termination and Notice to Vacate for Wrongful Assignment or Subleasing, Waste, Unlawful Business, nuisance or Violations of Controlled Substances Laws ­ NRS 40.2514. _____ 4. I have a written rental agreement which allows me to stay until _________________________, 20 ____. _____ 5. The notice which I received did not provide me with the statutorily required number of days as specified below: _____ A. _____ B. _____ C. _____ D. _____ 6. 30 days 7 days 5 days 3 days

I have received a 5-day notice alleging a breach of my lease and I _____ A. _____ B. did not breach it, or did not receive notice of my right to cure the alleged breach within 3 days under NRS 40.2516, or _____ C. did not receive notice of my right to cure the alleged breach within 5 days under NRS 118A.430, or _____ D. have cured, or used my best efforts to cure, the alleged breach within ________ days after receiving the notice, or _____ E. did not receive a subsequent 5-day notice called an unlawful detainer notice.

_____ 7.

Even though the terms of my original tenancy expired on ______________, 20____, the landlord has renewed my tenancy by either accepting rent for a new rental period and/or entering into a new rental agreement.

Apartment Tenant Affidavit/Declaration (Other than Nonpayment of Rent, Private Housing) Form #16

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_____ 8.

I have received a 3-day notice alleging that I have illegally subleased the rental unit , carried on an unlawful business or created a nuisance and I deny those allegations.

_____ 9.

I have received a 3-day notice pursuant to NRS 40.255 alleging that the rental unit has been foreclosed upon or sold. Summary eviction proceedings cannot be utilized following these notices. NRS 40.255 requires the landlord to proceed under NRS 40.290 - NRS 40.420 (formal unlawful detainer). This action should be dismissed.

_____ 10.

This action is brought in violation of the Federal Fair Housing Act or Nevada laws forbidding discrimination in housing, which provides me with a defense under NRS Chapter 118.115.

_____ 11.

I received a 30-day notice to vacate and am a tenant who is 60 years of age or older or who has a physical or mental disability. The Notice failed to notify me of my right to request to be allowed to continue in possession for an additional 30 days as required by NRS 40.251(3).

_____ 12.

The landlord issued the Notice as a retaliatory action in violation of NRS 118A.510 for my: _____ A. having complained of a health or safety violation to a government agency. _____ B. having complained to the landlord of a violation of the Nevada Landlord Tenant Act. _____ C. _____ D. organizing a tenants' union. having complained to the landlord of a violation of a statute imposing a criminal penalty, i.e.,(specify)________________ __________________________________________________ __________________________________________________

Apartment Tenant Affidavit/Declaration (Other than Nonpayment of Rent, Private Housing) Form #16

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_________________________________________________. _____ E. having complained to a law enforcement agency of a violation of the Nevada Landlord Tenant Act. _____ F. having complained to a law enforcement agency of a violation of a statute imposing a criminal penalty, i.e., (specify)_______ __________________________________________________ __________________________________________________ _________________________________________________. _____ G. having instituted or defended against a judicial administrative proceeding or arbitration in which I raised an issue of compliance with the legal requirements respecting the habitability of dwelling units. ______ H. having complained in good faith of a violation of the Federal Fair Housing Act or Nevada laws forbidding discrimination in housing to (specify): _____ 1. _____ 2. _____ 3. _____ 4. _____ 5. _____ I. the landlord a government agency a fair housing agency an attorney an appropriate body

having exercised rights which are guaranteed or protected

under the Federal Fair Housing Act or Nevada laws forbidding discrimination in housing. _____ 13. Other (explain):_______________________________________________ ___________________________________________________________ ___________________________________________________________
Apartment Tenant Affidavit/Declaration (Other than Nonpayment of Rent, Private Housing) Form #16 Revised: April 14, 2006

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__________________________________________________________ __________________________________________________________. WHEREFORE, the Tenant/Defendant prays for a hearing in this court pursuant to NRS Chapter 40, and that this matter be dismissed at the hearing because I have raised a legal defense to the alleged unlawful detainer _____ Request for a Stay. In the alternative, if the court concludes that I have not raised a legal defense, I request a stay of execution under the authority of NRS 70.010(2) of ________ days (up to 10) in order to move. I need the additional time because ___________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ __________________________________________________.

Apartment Tenant Affidavit/Declaration (Other than Nonpayment of Rent, Private Housing) Form #16

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I swear the above is true. Signature:__________________________________

SUBSCRIBED AND SWORN to before me this ____ day of _________________, 20____. NOTARY PUBLIC OR DEPUTY CLERK _____________________________

OR
THE FOLLOWING:

Pursuant to NRS 53.045: "I declare under penalty of perjury under the law of the State of Nevada that the foregoing is true and correct." Executed on _____________, 20____

______________________________ Signature

______________________________ Print Name

Apartment Tenant Affidavit/Declaration (Other than Nonpayment of Rent, Private Housing) Form #16

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Revised: April 14, 2006