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State: Minnesota
Category: Court Forms - State
Author: Mary Ann E. Archer
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State of Minnesota
Select County

District Court
Judicial District: Court File Number: Case Type: Housing

Plaintiff (Landlord)



Eviction Action Complaint (Minn. Stat. 504B.321)
Tenant's Date of Birth:
Address (If known)

Defendant (Tenant)

(name of person signing complaint)

state upon oath/affirmation: Landlord leased or rented to tenant(s) on in the city of The agreement was from due on the month is $ by an ORAL WRITTEN agreement the premises at: Apartment # , and garage YES NO, , the state of Minnesota, zip code , in the county of . The current rent due and payable under this agreement each day of the month. .



2. 3.

The landlord of the premises described above is Landlord having present right of possession of said property, has complied with Minn. Stat. 504B.181 by: a. disclosing to the tenant either in the rental agreement or otherwise in writing prior to beginning of the tenancy the name and address of: i. the person authorized to manage the property AND ii. a landlord or agent authorized by the landlord to accept service of process and receive and give receipt for notices and demands, AND b. posting in a conspicuous place on the property a printed or typewritten notice containing the above information , OR
Where Posted

c. 4.

the above information was known by the tenant not less than 30 days before the filing of this action because: .

Landlord seeks to have the tenant evicted for the following reasons: a. The tenant is still in possession of above premises and has failed to pay rent for the month(s) of per month payable on the day of each month for a total due of $ . in the amount of $ b. The tenant has failed to vacate property after tenant was given gave written notice to do so. This notice was and tenant Was Told Gave notice to vacate the property served on Tenant Landlord on . by c. The tenant has broken the terms of the rental agreement with property landlord by: (be specific)

d. 5.

The tenant has breached the covenants set forth in Minn. Stat. 504B.171 by: (be specific)

The landlord seeks judgment against the above tenant(s) for restitution of said premises plus costs and disbursements herein.

Verification and Affidavit of Non Military Status I, (Name) , being sworn/affirmed, state that I am the plaintiff/agent/attorney in this action, that I have read the complaint and that it is true to the best of my knowledge; that tenant(s) is/are not now in the military service of the United States, to the best of my information and belief. Dated: Signature (Sign only in front of notary public or court administrator.) Sworn/affirmed before me this day of , . Name: Address: City/State/Zip: Notary Public \ Deputy Court Administrator Telephone:




Rev 9/01

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