IN THE CIRCUIT COURT OF JACKSON COUNTY, MISSOURI



IN THE CIRCUIT COURT OF JACKSON COUNTY, MISSOURI

ASSOCIATE CIRCUIT COURT DIVISION

AT KANSAS CITY AT INDEPENDENCE

____________________________________________

PLAINTIFF(S) (MUST BE RECORDED TITLE OWNER)

____________________________________________ NO. ___________________________________

____________________________________________ PRINT ALL INFORMATION LEGIBLY

STREET ADDRESS Petition must be complete, signed and notarized

____________________________________________

CITY STATE ZIP (See Notice to Plaintiff for additional information

____________________________________________ prior to completing this form.)

TELEPHONE FAX NUMBER

____________________________________________

EMAIL ADDRESS

VS.

____________________________________________

DEFENDANT(S)/TENANT(S)

____________________________________________

____________________________________________ Jackson County Service Requested

SERVICE ADDRESS Private Process Server

____________________________________________

CITY STATE ZIP

____________________________________________

EMAIL ADDRESS

LANDLORD’S PETITION

____________________________________________, being duly sworn on oath states that the above-named Plaintiff is the recorded title owner of the property described herein and defendant(s)/tenant(s) now occupies as a tenant of plaintiff, the following premises at:_______________________________________________________________________, in Jackson County, Missouri. Said premises was rented to the defendant on ____________________, at the rate of $______________per month, payable monthly in advance. The sum of $_____________________ is now due plaintiff for said rent. In addition, the sum of $_______________ is due under the terms of the lease for the following: _________________________________________________________________________________________________

_________________________________________________________________________________________________

________________________________________________________________________________________________. The same has been demanded of defendant(s)/tenant(s) and payment has not been made. Plaintiff is the owner of the property and is a: (check one) Sole Proprietorship General Partnership Limited Liability Partnership Limited Liability Company Corporation.

Wherefore, Plaintiff prays for judgment for possession of said premises and for $_____________________ as provided above, and all rent or additional fees to accrue from the date of filing until date of judgment, and costs.

______________________________________________

PLAINTIFF/OWNER

AFFIDAVIT

STATE OF MISSOURI )

COUNTY OF JACKSON )

Personally appeared before me ________________________________, Plaintiff/Owner, who subscribed and swore to the facts contained within the foregoing document before me on ____________________________.

My Commission Expires:________________________ ________________________________________

CIRCT 4120 – 02/15 Notary Public

Notice to Plaintiff

• It is a Class A misdemeanor to make a false affidavit for the purpose of misleading a public official.

• All special process servers must be appointed by motion and order of the Court in compliance with Local Rule 4.9. All Local Rules may be found on the Court’s website, located at .

• The owner or owner’s attorney must appear in Court.

• If the owner is a Limited Liability Partnership, Limited Liability Company or a Corporation, the petition must be signed and filed by an attorney through the Court’s e-filing system, and the plaintiff must be represented by the attorney in Court.

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