Reilly's: 104 Military Affidavit Form

Please Check only one of the Following for Tenants Military Status!

Is in the military service and ON active duty in a foreign CountryIs in the military service and NOT on active duty in a foreign CountryIS NOT In the military service.HAS WAIVED his rights under the service members relief act of 2003Plaintiff is unable to determine whether or not defendant is in Military Service at this time (Only Reason this would be selected is if landlord does not have Date of Birth (DOB) and last name for each tenant.)
I am not providing this status due to the fact that I do not have last name and or date of birth.
In addition to this affidavit you MUST provide proof of military status before a default judgement can be rendered
Defendant’s address:

DEFENDANTS ADDRESS

Street Address Line 2

CITY STATE AND ZIP CODE

Postal / Zip Code
***DO NOT SIGN THE AFFIDAVIT UNTIL CLERK ASKS YOU TO!!*

I Understand
Please verify that you are human*
Should be Empty: