Form Ca 114 – Fill Out and Use This PDF

Check the box for the Civil Actions Branch (500 Indiana Ave, NW, Room 5000, Washington DC 20001, 202-879-1133), the Landlord & Tenant Branch (510 4th Street, NW, Room 110, Washington DC 20001, 202-879-4879) or the Small Claims & Conciliation Branch (510 4th Street, NW, Room 120, Washington DC 20001, 202-879-1120).

Enter the Case Caption and the Case No.

After 1. I, type or print your name clearly.

Check Plaintiff, Plaintiff's attorney, or Plaintiff's agent authorized to make this verification, and enter your relationship to the Plaintiff. If the person completing the form is the Plaintiff, leave the relationship to the Plaintiff line blank.

This affidavit is made pursuant to Section 3931 of the Servicemembers Civil Relief Act (50 U.S.C. § 3901 et seq.).

You state that you have caused a careful investigation to be made to ascertain whether the defendant is in the military service of the United States Army, Navy, Air Force, Marine Corps, Space Force, or Coast Guard; or a National Guard member called to active service for more than 30 consecutive days by the President or Secretary of Defense to respond to a national emergency; or a commissioned officer in active service of the Public Health Service or the National Oceanic and Atmospheric Administration. As a result of this investigation, check box A, B, C, or D and complete as instructed.

Check box A if the defendant is not in any of the named branches of the military service AND the defendant has not received notice of induction or notice to report for military service; AND, if this is an action for possession of real property, the premises are not occupied chiefly for dwelling purposes by the spouse, children, or other dependents of a person in military service. The facts supporting this conclusion: check all that apply and attach additional pages and documentation as necessary.

Check I have proof of the defendant's military status from the Department of Defense Manpower Data Center, and attach the certificate of non-military status.

Check I have contacted each branch of the military and have received confirmation from each branch that the defendant is not in military service, and attach the responses you received.

Check The defendant is not an individual and enter the type of business entity in Specify Type of Business Entity: it is a business entity and, therefore, no investigation of military service is required.

Check I asked the defendant personally on a Date, or check I spoke with a Name and Relationship to Defendant on a Date who has reason to know the defendant's military status because.

Check the box for reasons and explain.

Check box B if, after a careful investigation, you could not determine whether the defendant is in any of the named branches of the military service; whether the defendant received notice of induction or notice to report for military service; or, if this is an action for possession of real property, whether an occupant of the property is the spouse, child, or other dependent of a person in military service.

Then enter the efforts you have made to investigate the defendant's military status (attach additional pages and documentation as necessary).

Check box C if the defendant is in one of the named branches of the military service.

Enter the facts supporting this conclusion in the as-follows lines (attach additional pages and documentation as necessary).

Check box D if the defendant executed a waiver of rights under Section 3918 of the Servicemembers Civil Relief Act (50 U.S.C. § 3901 et seq.).

Attach a copy of the waiver, in at least 12-point type, signed by the defendant during or after his/her military service.

Under Section 3931 of the Servicemembers Civil Relief Act (2018) (50 U.S.C. § 3901 et seq.), you certify and declare under penalty of perjury that the information contained above is true.

Enter the Date and Printed Name, and sign on the Signature line.