IN THE MAGISRATE COURT OF
Name, Address & Phone Number of Petitioner:
COUNTY, WEST VIRGINIA
Name, Address & Phone Number of Respondent(s):
Petition for Summary Relief: Wrongful Occupation of Factory-Built Home Site
(W.Va. Code § 55-3B-4)
The above-named petitioner as the (check one)
Street or Road Address
agent of the owner of a factory-built home site located at
County Description (Lot No., etc.)
swears to or affirms the following as true: The petitioner has a right to recover possession of the property described above in that the above-named respondent(s) is/are wrongfully occupying such property as tenant(s) because (check each that applies): Tenant is holding over after having been given proper notice of termination of tenancy, whether or not tenant has continued to pay and landlord has accepted rent, or The landlord has good cause, specifically (W.Va. Code § 55-3B-1): Tenant is in arrears in the payment of periodic payments or other charges related to the tenancy: Tenant has breached material term of a written rental agreement or repeatedly breached other terms of a written agreement, including those agreements required in W.Va. Code § 37-15-3 specifically: Tenant breached the terms of the tenancy and the rent therefore (provide brief description)
; Tenant breached the rules and regulations of the factory-built home rental community (provide brief description)
Tenant breached the agreement concerning physical improvements and maintenance to be provided by the tenant and the landlord (provide brief description)
Tenant breached the agreement by failing to pay for services provided at the time of the execution of the rental agreement and throughout the terms of the tenancy, namely (provide brief description)
Copy Distribution W.Va. Code §§ 55-3B-1, 55-3B-4, 50-5-8(a), 37-15-3, Mag. Ct. Civ. Rule 6A
Return Respondent Petitioner
SCA-M231-1 / 09-04
PETITION FOR SUMMARY RELIEF, CASE NO. Other (provide brief description)
(Where there is no written agreement, or where written agreement does not cover subject matter of warranty or leasehold covenant) tenant has breached a material term of warranty or leasehold covenant or repeatedly breached other terms of warranty or leasehold covenant (provide brief description)
Tenant has deliberately or negligently damaged property or knowingly permitted another to do so.
WHEREFORE, the petitioner requests possession of the above-described property and, if any, the following additional relief from the court (check all that apply): eviction of the tenant and removal of the tenant s factory built home. past due rent payment in the amount of $ .
other agreed charges related to the tenancy (specifically describe relief requested):
Taken, subscribed and sworn or affirmed before me this
. My commission expires
NOTICE: Any party in a civil action seeking over $20.00 or possession of real estate has the right to elect that the case be tried by a jury. You must give written notice to the magistrate court 5 days from when service of the summons and petition is made for wrongful occupation actions. If you do not notify the magistrate court within the appropriate time period, you give up your right to a jury trial. The jury fee will be assessed against the losing party if the case is tried by a jury or may be prorated between the parties if the case is settled before trial. (OPTIONAL) NOTICE OF ELECTION: As petitioner in the above action, I wish to have a jury trial.
NOTICE: Any person involved in court proceedings who has a disability and needs special accommodation should inform the court sufficiently in advance so that arrangements can be made if possible.
Copy distribution Return Respondent W. Va. Code §§ 55-3B-1, 55-3B-4, 50-5-8(a); 37-15-3, Mag. Ct. Civ. Rule 6A SCA-M231-2 / 09-04 File Petitioner