STATE OF INDIANA

COUNTY OF DELAWARE
)
) SS:
)
IN THE DELAWARE CIRCUIT COURT NO.

CASE NUMBER:
Plaintiff(s)
vs.
Defendant(s)
PROPERTY STATUS CERTIFICATION AFFIDAVIT

I as the owner/property manager of the real estate commonly known as

(Address)

which is the subject matter of this case affirms the property is a:

Covered property
  • I have reviewed the CARES Act on evictions for non-payment of rent from federally-subsidized housing and federally-backed mortgages.
  • I am not filing this claim prior to the expiration of the 30-day notice sent to the tenant.
  • I have received funds under the Act and sent a 30-day notice to vacate that is attached to this Notice of Claim for Possession of Real Estate.
OR
Non-covered property
  • The property associated with Notice of Claim for Possession of Real Estate is a not a federally-subsidized apartment, and is not supported by HUD, USDA or the Treasury (Low Income Housing Tax Credit). Further, if the home is a single-family dwelling, I verify that the property is not backed by a federally financed mortgage through FHA, Fannie Mae, and Freddie Mac mortgage.

I affirm, under the penalties for perjury, that the foregoing representation is true to the best of my knowledge and belief.

Date
Landlord/Attorney for Landlord Signature
Certificate of Service

I hereby certify that a copy of this document was sent to the parties or their counsel by
(US Mail, E-Service, Sheriff, other manner allowed by IN Trial Rules).

Date
Landlord/Attorney for Landlord Signature